Clinical and Population Studies |
From the the Division of Cardiology (V.R.S.F., B.D.R., D.A.B., J.A.C.L.), Johns Hopkins University, Baltimore, Md; the Department of Radiology (J.F.P.), Tufts-New England Medical Center, Boston, Mass; the Division of Cardiovascular Medicine (S.C.), Brigham and Womens Hospital, Harvard University, Boston, Mass; the Department of Biostatistics (B.C.), Johns Hopkins University Bloomberg School of Public Health, Baltimore, Md; Cardiac Imaging (K.N.), Massachusetts General Hospital; the Department of Biostatistics (R.M.), University of Washington; the Department of Internal Medicine/Cardiology (G.H.), Wake Forest University Health Sciences, Winston-Salem, NC; the Department of Radiology (G.P.), Columbia University, New York; and Caritas Carney Hospital (D.H.O.), Department of Radiology (D.A.B., J.A.C.L.), Johns Hopkins University, Baltimore, Md.
Correspondence João A.C. Lima, MD, Division of Cardiology, Blalock 524, Johns Hopkins Hospital, 600 N. Wolfe Street, Baltimore, MD 21287-0409. E-mail jlima{at}jhmi.edu
Abstract
Objective— The pathophysiology of left ventricular (LV) dysfunction, particularly in the setting of a preserved ejection fraction (EF), remains unclear. Few studies have investigated the relationship between arterial compliance and LV function in humans, and none used cardiovascular MRI.
Methods and Results— We sought to determine whether arterial compliance is related to regional myocardial function among participants of the Multi-Ethnic Study of Atherosclerosis (MESA). Arterial compliance was assessed using carotid ultrasound measurements to calculate the distensibility coefficient (DC) and Youngs modulus (YM). Circumferential systolic (SRS) and diastolic (SRE) strain rates were calculated by harmonic phase (HARP) from tagged MRI. Associations between arterial compliance and indices of ventricular function were adjusted for cardiovascular risk factors. We found a significant association between arterial compliance and SRS in all myocardial regions (P<0.05); arterial compliance was also associated with SRE in the lateral and septal wall regions (P<0.05). Multiple linear regression analyses demonstrated a direct linear relationship between the carotid artery DC and SRS across all LV segments and slices, even after adjustment for cardiovascular risk factors and LV mass. In regression analyses, a significant relationship between arterial compliance and SRE in the septal and antero-apical walls was also found and remained significant after multivariable adjustment.
Conclusion— Arterial stiffness is associated with early and asymptomatic impairment of systolic as well as diastolic myocardial function. Further studies are needed to elucidate role of vascular compliance in the development of ventricular dysfunction and failure.
We sought to determine whether or not arterial compliance is related to regional myocardial function among participants of the Multi-Ethnic Study of Atherosclerosis. We found a significant association between arterial compliance and regional myocardial function (SRS and SRE). Arterial stiffness is associated with early and asymptomatic impairment of regional myocardial function.
Key Words: arterial stiffness regional ventricular function heart failure tagging MRI strain rate
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