Clinical Investigation
Vascular Disease and LV Diastolic Function
Carotid Artery Stiffness and Diastolic Function in Subjects without Known Cardiovascular Disease

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Background

The aim of this study was to investigate the relationship between carotid artery stiffness and diastolic function in a cohort of subjects without known cardiovascular risk factors and/or overt cardiovascular disease.

Methods

Ninety-two healthy subjects underwent transthoracic echocardiographic Doppler and carotid echo-tracking studies. Measurements of local arterial stiffness were obtained at left common carotid artery level; stiffness parameter (β), and pressure-strain elasticity modulus (Ep) were calculated as well as intima-media thickness (IMT).

Results

Stiffness parameter and Ep were correlated inversely with transmitral E wave (P < .01), E/A ratio, and septal Em (P < .01) and positively with A wave (P < .001). IMT was also associated with A wave, E/A ratio, Em, and Am but not with E wave. No association was found between IMT, β, and Ep. The correlation between arterial stiffness and left ventricular diastolic function remained significant after multivariate adjustment for age, sex, pulse pressure, and body mass index, but not with IMT.

Conclusions

In healthy subjects, changes in central carotid stiffness are in line with left ventricular diastolic function independently of age, sex, pulse pressure, and body mass index.

Section snippets

Study Protocol

Ninety-two consecutive Caucasian volunteers without known cardiovascular risk factors and/or overt cardiovascular disease (58 men, 34 women; mean age, 46.0 ± 13.3 years) were enrolled. The study population, referred to the local hospital, had undergone voluntary screening for cardiovascular disease at our outpatient clinic, which included a questionnaire about medical history, the use of drugs in the previous 5 years, cardiovascular risk factors, and lifestyle habits (alcohol intake, smoking,

Results

Study population characteristics, echocardiographic parameters, and arterial stiffness variables are shown in Table 1.

Correlations between β and Ep and diastolic function indices are presented in Table 2. The correlations were negative with E and Em waves and E/A ratio and positive with the late portion of diastolic function (A wave) and deceleration time. Am and E/Em ratio were not correlated with β and Ep. IMT was also associated with A wave, E/A ratio, Em, and Am but not with E wave (Table 2

Discussion

To the best of our knowledge, some data are available on the association between arterial stiffness and diastolic function among subjects with cardiovascular risk factors,17, 18, 19, 20, 21, 22 but little is known about this association in subjects free of overt cardiovascular risk factors.

It has been shown that the local measurement of arterial stiffness may be useful for the detection of early arterial changes23 and as a predictor of adverse cardiovascular events, because it can reflect large

Conclusions

Among subjects without known cardiovascular disease and not taking medications, changes in central carotid stiffness are in line with LV diastolic function independently of age, sex, PP, and BMI. Moreover, the present study demonstrated that in these subjects, there is not complete agreement between arterial stiffness and IMT, confirming that the β, Ep, and IMT measurements used to assess arterial stiffness in clinical practice are not interchangeable.

Multiple plausible explanations for this

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