P31 DO TREATMENT INDUCED CHANGES IN ARTERIAL STIFFNESS AFFECT LEFT VENTRICULAR STRUCTURE AND FUNCTION? – A META-ANALYSIS

Abstract

Background: Vascular research demonstrated that pulse wave velocity (PWV), a measure of arterial stiffness, is inherently blood pressure-dependent. Considering the hypothesised pathophysiological chain of increased arterial stiffness leading to increased blood pressure load with consequent left ventricle hypertrophy (LVH) development, we conducted a systematic review of antihypertensive and lifestyle intervention studies to determine the association between on the one hand changes in arterial stiffness and blood pressure, and on the other hand changes in LV mass (LVM). Methods: Using PubMed, EMBASE, Cochrane and Web of Science, we identified 23 studies, containing 2573 patients. Studies reported changes in arterial stiffness (assessed by means of PWV), systolic- and diastolic blood pressure (SBP, DBP), and LVM index (LVMI), respectively. Results: Statistically significant reductions in SBP, PWV and LVMI were reported in 16, 14, and 20 studies, respectively. Pooled analysis of studies showed that the proportion in SBP reduction did not correlate significantly to the proportion in reductions of the other two variables. On the other hand, we found a significant positive correlation (r = 0.58, p = 0.007) between arterial stiffness and LVM regression, expressed as a relevant reduction in LVMI of 6.5 g/m2 per 1.0 m/s reduction in PWV. Conclusions: Our findings provide evidence that a decrease in arterial stiffness is associated with regression of LVH. To investigate whether there exists a causal relation between LVH due to arterial stiffness increases and in turn blood pressure load increases, future studies should strive for a multiple followup design and use of blood pressure-independent or -corrected stiffness indices.