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The change in arterial stiffness over the cardiac cycle rather than diastolic stiffness is independently associated with left ventricular mass index in healthy middle-aged individuals

(2012) JOURNAL OF HYPERTENSION. 30(2). p.396-402
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Abstract
Background: The current standard for arterial stiffness assessment, aortic pulse wave velocity (aPWV), is measured at diastolic pressure. Arterial stiffness, however, is pressure dependent. At the carotid artery level, the degree of this dependency can be quantified as the difference (Delta PWV) between systolic and diastolic (cPWV(d)) carotid pulse wave velocity. Biomechanically, a greater Delta PWV implies greater increases in left ventricular afterload with physical activity. Therefore, we hypothesized, that Delta PWV is more strongly associated with left ventricular mass index (LVMI) than aPWV and cPWV(d). Methods: In 1776 healthy individuals from the Asklepios cohort (age 35-55 years), Delta PWV was obtained from combined carotid artery ultrasound and tonometry recordings. Multiple linear regression analysis was performed to investigate the associations of Delta PWV, cPWV(d) and aPWV with LVMI, adjusting for age, sex, mean blood pressure (MBP), central pulse pressure, and other possible confounders. Results: DPWV was 2.4 +/- 1.2 m/s (mean +/- SD), ranging from 0.8 m/s, indicating almost constant arterial stiffness over the cardiac cycle, to 4.4 m/s, reflecting substantial pressure dependency. Delta PWV was significantly associated with LVMI (beta of 2.46 g/m(1.7) per m/s, P < 0.001), even after full adjustment (beta of 0.56 g/m(1.7) per m/s, P = 0.03). cPWV(d) and aPWV had clear crude associations with LVMI (P < 0.001), but lost significance after adjustment (beta of -0.48 and -0.33 g/m(1.7) per m/s, with P = 0.11 and 0.2, respectively). Conclusion: The change in arterial stiffness over the cardiac cycle, rather than diastolic stiffness, is independently associated with LVMI in healthy middle-aged individuals. Therefore, the pressure dependency of arterial stiffness should be considered in cardiovascular risk assessment.
Keywords
cardiac hypertrophy/remodeling, ventricular-arterial coupling, pulse wave velocity, systolic hypertension, arterial structure and compliance, PULSE-WAVE VELOCITY, CAROTID-ARTERY, MECHANICAL-PROPERTIES, HYPERTENSIVE PATIENTS, AORTIC STIFFNESS, BLOOD-PRESSURE, DIAMETER, EXERCISE, HYPERTROPHY, GUIDELINES

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Citation

Please use this url to cite or link to this publication:

Chicago
Hermeling, Evelien, SEBASTIAN VERMEERSCH, Ernst Rietzschel, Marc De Buyzere, Thierry Gillebert, Roel J van de Laar, Isabel Ferreira, et al. 2012. “The Change in Arterial Stiffness over the Cardiac Cycle Rather Than Diastolic Stiffness Is Independently Associated with Left Ventricular Mass Index in Healthy Middle-aged Individuals.” Journal of Hypertension 30 (2): 396–402.
APA
Hermeling, Evelien, VERMEERSCH, S., Rietzschel, E., De Buyzere, M., Gillebert, T., van de Laar, R. J., Ferreira, I., et al. (2012). The change in arterial stiffness over the cardiac cycle rather than diastolic stiffness is independently associated with left ventricular mass index in healthy middle-aged individuals. JOURNAL OF HYPERTENSION, 30(2), 396–402.
Vancouver
1.
Hermeling E, VERMEERSCH S, Rietzschel E, De Buyzere M, Gillebert T, van de Laar RJ, et al. The change in arterial stiffness over the cardiac cycle rather than diastolic stiffness is independently associated with left ventricular mass index in healthy middle-aged individuals. JOURNAL OF HYPERTENSION. 2012;30(2):396–402.
MLA
Hermeling, Evelien, SEBASTIAN VERMEERSCH, Ernst Rietzschel, et al. “The Change in Arterial Stiffness over the Cardiac Cycle Rather Than Diastolic Stiffness Is Independently Associated with Left Ventricular Mass Index in Healthy Middle-aged Individuals.” JOURNAL OF HYPERTENSION 30.2 (2012): 396–402. Print.
@article{2037722,
  abstract     = {Background: The current standard for arterial stiffness assessment, aortic pulse wave velocity (aPWV), is measured at diastolic pressure. Arterial stiffness, however, is pressure dependent. At the carotid artery level, the degree of this dependency can be quantified as the difference (Delta PWV) between systolic and diastolic (cPWV(d)) carotid pulse wave velocity. Biomechanically, a greater Delta PWV implies greater increases in left ventricular afterload with physical activity. Therefore, we hypothesized, that Delta PWV is more strongly associated with left ventricular mass index (LVMI) than aPWV and cPWV(d). 
Methods: In 1776 healthy individuals from the Asklepios cohort (age 35-55 years), Delta PWV was obtained from combined carotid artery ultrasound and tonometry recordings. Multiple linear regression analysis was performed to investigate the associations of Delta PWV, cPWV(d) and aPWV with LVMI, adjusting for age, sex, mean blood pressure (MBP), central pulse pressure, and other possible confounders. 
Results: DPWV was 2.4 +/- 1.2 m/s (mean +/- SD), ranging from 0.8 m/s, indicating almost constant arterial stiffness over the cardiac cycle, to 4.4 m/s, reflecting substantial pressure dependency. Delta PWV was significantly associated with LVMI (beta of 2.46 g/m(1.7) per m/s, P {\textlangle} 0.001), even after full adjustment (beta of 0.56 g/m(1.7) per m/s, P = 0.03). cPWV(d) and aPWV had clear crude associations with LVMI (P {\textlangle} 0.001), but lost significance after adjustment (beta of -0.48 and -0.33 g/m(1.7) per m/s, with P = 0.11 and 0.2, respectively). 
Conclusion: The change in arterial stiffness over the cardiac cycle, rather than diastolic stiffness, is independently associated with LVMI in healthy middle-aged individuals. Therefore, the pressure dependency of arterial stiffness should be considered in cardiovascular risk assessment.},
  author       = {Hermeling, Evelien and VERMEERSCH, SEBASTIAN and Rietzschel, Ernst and De Buyzere, Marc and Gillebert, Thierry and van de Laar, Roel J and Ferreira, Isabel and Hoeks, Arnold P and Van Bortel, Lucas and Reneman, Robert S and Segers, Patrick and Reesink, Koen D},
  issn         = {0263-6352},
  journal      = {JOURNAL OF HYPERTENSION},
  keyword      = {cardiac hypertrophy/remodeling,ventricular-arterial coupling,pulse wave velocity,systolic hypertension,arterial structure and compliance,PULSE-WAVE VELOCITY,CAROTID-ARTERY,MECHANICAL-PROPERTIES,HYPERTENSIVE PATIENTS,AORTIC STIFFNESS,BLOOD-PRESSURE,DIAMETER,EXERCISE,HYPERTROPHY,GUIDELINES},
  language     = {eng},
  number       = {2},
  pages        = {396--402},
  title        = {The change in arterial stiffness over the cardiac cycle rather than diastolic stiffness is independently associated with left ventricular mass index in healthy middle-aged individuals},
  url          = {http://dx.doi.org/10.1097/HJH.0b013e32834e4b75},
  volume       = {30},
  year         = {2012},
}

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