Aim: To evaluate the relationship of arterial stiffness and left ventricular diastolic dysfunction (LVDD) in metabolic syndrome (MetS) patients.
Methods: A cross-sectional study was carried among 1208 MetS subjects (aged 54±6, 65% women, 92% hypertensive) without overt atherosclerotic disease and systolic LV dysfunction. According to cardiac ultrasound findings, patients were divided into two groups: with LVDD (LVDD+, n=382 with relaxation abnormalities and n=742 with pseudonormalisation) and without LVDD (LVDD-, n=84). Arterial stiffness parameters (carotid to femoral pulse wave velocity, cfPWV, aortic augmentation index, AIxHR75), were assessed by applanation tonometry.
Results: In comparison to LVDD- patients, LVDD+ patients were older (55±6 vs. 51±6) and had higher cfPWV (8.8±1.6 vs. 7.9±1.4 m/s), AIxHR75 (24.7±10.3 vs. 19.5±10.2 %), mean arterial pressure (108±13 vs. 101±10 mmHg), heart rate (66±10 vs. 61±9), LV mass index (LVMI, 109±24 vs. 98±22), body mass index (32±5 vs. 30±4 kg/m2), insulin sensitivity index HOMA-IR (3.8±3.4 vs. 2.9±1.4, all p<0.05). When all these factors were entered into logistic regression analysis, only age (p=0.02), cfPWV (p=0.04) and LVMI (p=0.02) remained significant predictors of the presence of LVDD (p<0.05).
We found significant correlations between arterial stiffness indices and various diastolic function parameters, such as ratio of early to late transmitral pulse Doppler velocities (E/A) (rcfPWV = –0.19, rAIxHR75 = –0.15, p < 0.05), early diastolic mitral annular velocity (E’) (rcfPWV = –0.25, rAIxHR75 = –0.18, p < 0.05), E/E’ ratio (rcfPWV = 0.17, rAIxHR75 = 0.14, p < 0.05). In the multiple regression analysis, gender, mean arterial pressure, LVMI, heart rate, cfPWV remained significant determinants of E/E’parameter, explaining 18% of its variability (p<0.05).
Conclusion. Carotid to femoral pulse wave velocity, an index of aortic stiffness, is a significant and independent determinant of the LVDD in subjects with metabolic syndrome.
Research is funded by the European Social Fund under the Global Grant measure.
