Cardiac Diastolic Dysfunction is Associated With Aortic Wave Reflection, but Not Stiffness in a Predominantly Young-to-Middle–Aged Community Sample

Abstract

In a predominantly young-to-middle-aged community sample, the impact of Pbs on LV DD antedates the effects of aortic stiffness, the time-to-wave reflection, or Pfs.

Deep Phenotyping of Systemic Arterial Hemodynamics in HFpEF (Part 2): Clinical and Therapeutic Considerations

“…In support of the large body of animal experimental findings demonstrating a cause-effect relationship between mid-to-late systolic load and impaired LV relaxation, several human studies demonstrate that indices of wave reflections and/ or mid-to-late systolic myocardial wall stress (MWS) are independently associated with diastolic dysfunction [18, 31, 34, 38–46], left atrial remodeling [40, 47, 48], decreased longitudinal systolic function (despite preserved EF) [42, 49], and elevated brain natriuretic peptide levels [41, 45, 50, 51]. …”

Doppler indexes of left ventricular systolic and diastolic function in relation to haemodynamic load components in a general population

“…Ã P < 0.05. y P < 0.01. population [15,24]. Both studies did not report details on the software's feasibility in their cohorts [15,24]. In our community-based cohort, this automated WSA algorithm often failed to derive the haemodynamic load components particularly in older women with an unfavourable haemodynamic status.…”

“…Previous studies suggested that the detrimental effects of increased central haemodynamics on LV diastolic dysfunction and left atrial volume might be mediated by the haemodynamic loads of both the Pf and Pb waves. For instance, in 524 young-to-middle aged participants [15], E/e 0 ratio reflected LV-filling pressure was independently associated with both haemodynamic load components. These observations are in line with our findings.…”

“…MAP, mean arterial pressure; Pb, backward wave amplitude; Pf, forward wave amplitude; PP, pulse pressure. Ã P < 0.05. y P < 0.01. population [15,24]. Both studies did not report details on the software's feasibility in their cohorts [15,24].…”

“…Previous population studies showed that increased central pulsatility has detrimental effects on LV diastolic function, especially in elderly women [9][10][11][12][13]. Moreover, it was suggested [14,15] that the impact of central haemodynamics on LV structure and function might be mediated by the haemodynamic loads of forward (Pf) and backward (Pb) pulse waves and their ratio, that is reflection magnitude.…”