PO-12 RELATIONS BETWEEN AORTIC STIFFNESS AND LEFT VENTRICULAR MECHANICAL FUNCTION

Abstract

Objectives: Left ventricular contraction produces longitudinal strain in the proximal aorta. As a result, aortic stiffening may impair optimal mechanical ventricular-vascular coupling and left ventricular (LV) systolic function, particularly in the long axis. LV global longitudinal strain (GLS) has recently emerged as a sensitive measure of early cardiac dysfunction. In this study, we investigated the relation between aortic stiffness and GLS in a large community-based sample. Methods: In 2516 participants (age 39–90 years, 57% women) of the Framingham Offspring and Omni cohorts, free of cardiovascular disease, we performed tonometry to measure aortic stiffness and echocardiography to assess cardiac function. Aortic stiffness was evaluated as carotid-femoral pulse wave velocity (CFPWV) and as characteristic impedance (Zc), and GLS was calculated using speckle tracking-based measurements. Results: In multivariable analyses adjusting for age, sex, height, systolic blood pressure, augmentation index, LV structure, and additional cardiovascular disease risk factors, increased CFPWV (β±SE: 0.122±0.030 SD strain per SD CFPWV, P<0.0001) and Zc (0.091±0.029 SD/SD, P=0.002) were both associated with worse (less negative) GLS. We observed effect modification by sex of the relation between Zc and GLS (P=0.004); in sex-stratified multivariable analyses, the relation between greater Zc and worse GLS persisted in women (0.145±0.040, P=0.0003) but not in men (P=0.73). Conclusion: Higher aortic stiffness was associated with worse GLS after adjusting for hemodynamic variables. Parallel reductions in LV long axis shortening and proximal aortic longitudinal strain in individuals with a stiffened proximal aorta may represent a manifestation of abnormal direct mechanical ventricular-vascular coupling.