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Early contribution of arterial wave reflection to left ventricular relaxation abnormalities in a community-dwelling population of normotensive and untreated hypertensive men and women

Journal of Human Hypertension volume 28, pages 85–91 (2014)Cite this article

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Abstract

We examined the contribution of arterial wave reflection to early abnormalities in left ventricular relaxation, whether this association was modified by gender or hypertension and the role of reflected wave timing and amplitude. We studied a cohort of normotensive and untreated essential hypertensive Taiwanese participants (675 men, 601 women, mean age 52 years). Doppler flow and applanation tonometry were performed to assess carotid–femoral pulse wave velocity (PWV) and augmentation index (AI). Diastolic parameters including the ratio between the peak velocity of early and late diastolic mitral inflow (E/A), E-deceleration time and left atrial (LA) diameter were measured by echocardiography. In multivariate models predicting E/A, women were more likely to have lower E/A than men (β=−0.08, P<0.001). AI was significantly associated with lower E/A in both men (β=−0.09, P=0.005) and women (β=−0.12, P<0.001) independent of PWV. Inclusion of AI in the overall model reduced the gender difference in E/A by 61% and rendered it nonsignificant. There was a significant interaction between AI and hypertension (P=0.02). The inverse association between AI and E/A was significant only in normotensive men and women, and only for the amplitude but not timing of the reflected wave. In conclusion, the contribution of wave reflection to left ventricular diastolic dysfunction was independent of arterial stiffness, more pronounced in normotensive individuals and explained a significant portion of the gender difference in diastolic function.

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Acknowledgements

This research was supported by the Intramural Research Program of the NIH, National Institute on Aging, a grant from the National Science Council (NSC 99-2314-B-010 -034 -MY3) and an intramural grant (V99C1-091) from Taipei Veterans General Hospital, Taiwan, Republic of China.

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Author notes

  1. M Canepa and M AlGhatrif: These two authors contributed equally to this work.

Authors and Affiliations

  1. Laboratory of Cardiovascular Sciences, Human Cardiovascular Studies Unit, National Institute on Aging, NIH, Baltimore, MD, USA

    M Canepa, M AlGhatrif, J B Strait & E G Lakatta

  2. Longitudinal Studies Section, Translational Gerontology Branch, National Institute on Aging, NIH, Baltimore, MD, USA

    M Canepa, J B Strait & L Ferrucci

  3. Division of Cardiology, Research Center of Cardiovascular Biology, University of Genova, Genova, Italy

    M Canepa & C Brunelli

  4. Department of Medicine, Johns Hopkins Bayview Medical Center, Johns Hopkins School of Medicine, Baltimore, MD, USA

    M AlGhatrif

  5. Department of Medical Research and Education, Taipei Veterans General Hospital, Taipei, Taiwan

    H-M Cheng & C-H Chen

  6. Department of Medicine, National Yang-Ming University, Taipei, Taiwan

    H-M Cheng & C-H Chen

  7. Division of Preventive Medicine and Health Service, Research Institute of Population Health Sciences, National Health Research Institutes, Miaoli, Taiwan

    S-Y Chuang

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  1. M Canepa
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Correspondence to M Canepa.

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Canepa, M., AlGhatrif, M., Strait, J. et al. Early contribution of arterial wave reflection to left ventricular relaxation abnormalities in a community-dwelling population of normotensive and untreated hypertensive men and women. J Hum Hypertens 28, 85–91 (2014). https://doi.org/10.1038/jhh.2013.86

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