Central aortic pressure is independently associated with diastolic function

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• 作者：Sumeet Subherwal ; Lisa de las Fuentes ; Alan D. Waggoner ; Sharon Heuerman ; Karen E. Spence ; Victor G. Davila-Roman
• 刊名：American Heart Journal
• 出版年：2010
• 出版时间：June 2010
• 年：2010
• 卷：159
• 期：6
• 页码：1081-1088
• 全文大小：282 K

文摘

lass=""h4"">Background

Studies investigating the association between central aortic pressures and diastolic function have been limited.

lass=""h4"">Methods

Consecutive ambulatory patients (n = 281, mean age 49 ± 13 years, 49 % male) with normal left ventricular (LV) systolic function were included. The LV filling pressure (E/Em) was estimated by Doppler-derived ratio of mitral inflow velocity (E) to septal (Em) by tissue Doppler, LV relaxation by Em, and central aortic pressures by radial tonometry. Central aortic systolic (cSBP), diastolic (cDBP), mean (cMAP) and pulse pressure (cPP) were entered individually into stepwise linear regression models to determine their association with E/Em or Em.

lass=""h4"">Results

In univariate analysis, cPP correlated most strongly with E/Em (Spearman's ρ = 0.45, P < .001), whereas cSBP correlated most strongly with Em (Spearman's ρ = −0.51, P < .001). Multivariate analysis demonstrated that the pulsatile component of afterload, cPP, contributed most to E/Em (partial r² = 23 % ); meanwhile, the nonpulsatile components (cDBP and cMAP) were significant but small contributors (partial r² of 6 % and 5 % , respectively) of LV relaxation (Em).

lass=""h4"">Conclusion

The nonpulsatile components of aortic afterload (cMAP and cDBP) exhibited a weak but significant association with LV relaxation, whereas the pulsatile component of afterload, cPP, exhibited strong association with LV filling pressure.