P183 INCREASED ARTERIAL STIFFNESS IS ASSOCIATED WITH POORER LEFT VENTRICULAR STRUCTURE AND FUNCTION IN ADOLESCENCE

Abstract

Introduction: Increased arterial stiffness (AS) in adults causes increased left ventricular (LV) afterload, putting additional strain on the heart. Long-term, this can lead to an adverse cardiovascular phenotype and AS has been found to be a determinant of CVD, independent of traditional cardiovascular risk factors. However, limited evidence exists for this association in children and adolescents. Methods: 1625 young adults (age 17y; 46% male) from the Avon Longitudinal Study of Parents and Children (ALSPAC), a UK based birth cohort, underwent echocardiography and carotid-to-femoral pulse wave velocity (PWV) measures. Linear regression was used to investigate associations between PWV and LV structure and function, including LV mass, relative wall thickness (RWT), left atrial diameter (LAD), mitral inflow (E:A), midwall fractional shortening (MFS) and tissue Doppler peak systolic velocity (s′). Results: Elevated PWV was associated with increased LV mass and RWT and inversely associated with E:A and MFS (Table 1). Adjustment for age and sex attenuated the association with LV mass. Further adjustment for body mass index (BMI), systolic blood pressure (SBP), alcohol, smoking and socioeconomic status (SES) attenuated the association with RWT, whilst the associations with E:A and MFS remained. Unadjusted Age and sex adjusted Age, sex, BMI, SBP, alcohol, smoking, SES adjusted Coefficient±SE P value Coefficient±SE P value Coefficient±SE P value LV mass2.7 (g/m2.7) 0.55±0.21 0.009 −0.066±0.225 0.768 −0.123±0.225 0.584 RWT 0.007±0.002 <0.001 0.008±0.002 <0.001 0.005±0.00 0.069 LAD (cm) −0.004±0.015 0.784 −0.017±0.015 0.268 −0.010±0.016 0.516 E:A −0.054±0.014 <0.001 −0.073±0.015 <0.001 −0.067±0.019 <0.001 MFS (%) −0.40±0.079 <0.001 −0.246±0.085 0.004 −0.232±0.1 0.022 s′ (cm/s) 0.078±0.05 0.138 0.004±0.057 0.937 −0.038±0.067 0.567 Conclusion: Increased AS is already associated with poorer measures of LV structure and function in adolescence. Adjustment for potential confounders did not substantially attenuate these associations with LV function.