Inter-relationships between left ventricular mass, geometry and arterial stiffness

Abstract

Objective: To investigate the inter-relationships between left ventricular mass (LVM), left ventricular (LV) geometry and arterial stiffness parameters (aortic pulse wave velocity [Ao-PWV] and heart rate-corrected augmentation index [c-AIx]) in patients with chronic heart failure (CHF).

Methods: This study was a secondary analysis of existing data that were collected from patients with CHF New York Heart Association class I–III with reduced ejection fraction (HFrEF) or preserved ejection fraction (HFpEF). Transthoracic echocardiography was performed on all patients, along with measurement of arterial stiffness parameters (Ao-PWV and c-AIx) using sphygmocardiography.

Results: A total of 73 patients (58 males) with a mean ± SD age of 55.9 ± 11.6 years were enrolled in this study. Of these, 20 patients (27.4%) had systemic hypertension, 46 (63.0%) had type 2 diabetes mellitus. Ischaemic heart disease was the main aetiology of CHF (63 of 73 patients; 86.3%). In multiple linear regression, the left ventricular mass index (LVMI) was significantly associated with c-AIx (β = –1.59) and EF (β = –1.51). Comparison of Ao-PWV among the four LV geometric patterns revealed significant differences.

Conclusion: In this cohort of CHF patients, LVMI was predicted by c-AIx and EF. The corresponding values of Ao-PWV were parallel in different LV geometric patterns and confirmed their adverse prognostic values.

Keywords: Arterial stiffness; aortic pulse wave velocity; augmentation index; chronic heart failure; left ventricular geometry; left ventricular hypertrophy; left ventricular mass index.

Figure 1.

Scatterplot of left ventricular mass index (LVMI) versus systolic blood pressure in patients based on presence of left ventricular hypertrophy (LVH). Patients without LVH (A; n=53) and patients with LVH (B; n=20).

Figure 2.

Scatterplot of left ventricular mass index (LVMI) versus systolic blood pressure in patients based on whether they had preserved ejection fraction (HFpEF; A; n = 26) or reduced ejection fraction (HFrEF; B; n = 47).

Figure 3.

Scatterplot of left ventricular mass index (LVMI) versus heart rate-corrected augmentation index (c-AIx) in patients stratified according to their pulse wave type (type A, 55 patients; type B, nine patients; type C, one patient; type D, eight patients).