Author:

Keywords:

Science & Technology, Life Sciences & Biomedicine, Cardiac & Cardiovascular Systems, Cardiovascular System & Cardiology, applanation tonometry, echocardiography, global longitudinal strain, population study, pulse wave velocity, ventricular-arterial coupling, GLOBAL LONGITUDINAL STRAIN, HYPERTROPHY, STIFFNESS, ventricular‐arterial coupling, Humans, Female, Male, Middle Aged, Reference Values, Heart Ventricles, Echocardiography, Predictive Value of Tests, Adult, Ventricular Function, Left, Carotid-Femoral Pulse Wave Velocity, Reproducibility of Results, Pulse Wave Analysis, Aged, 1S07421N|1S07423N#55402769, G0C5319N#54970012, C24M/21/025#56284781, DB/22/010/BM#56773459, 1102 Cardiorespiratory Medicine and Haematology, Cardiovascular System & Hematology, 3201 Cardiovascular medicine and haematology

Abstract:

PURPOSE: Noninvasive imaging markers combining ventricular and arterial properties may help predict cardiac disease. We conducted a general population study to determine reference values, clinical correlates, and the predictive value of the ratio of the carotid-femoral pulse wave velocity (cfPWV) to the left ventricular global longitudinal strain (GLS). METHODS: We measured cfPWV by applanation tonometry and 4-chamber GLS by echocardiography in 1026 individuals (mean age 50.3 years; 52% women). We derived reference values for cfPWV/GLS from a low-risk subsample. Clinical correlates of cfPWV/GLS were determined by stepwise regression. We calculated multivariable-adjusted hazard ratios (HR) for incident cardiovascular (CV) events (median follow-up: 10.1 years). RESULTS: Upper limits of normality for cfPWV/GLS varied with sex and age, ranging from 0.41 m/s% in young women up to 0.64 m/s% in older men. Higher cfPWV/GLS correlated directly with male sex, age, heart rate, pulse pressure, mean arterial pressure, and left ventricular mass (p < 0.05 for all). On a continuous scale, only GLS was a significant predictor of CV events after adjustment (HR per 1% decrease: 1.11; p = 0.0078). A cfPWV/GLS ratio above the median (>0.37 m/s%) did predict future CV events after adjustment (HR vs. below median: 2.02; p = 0.0067). However, abnormal cfPWV/GLS defined by reference limits or by cutoffs from literature did not independently predict CV events (p ≥ 0.31 for all). CONCLUSION: Age- and sex-specific reference values for cfPWV/GLS were reported. cfPWV/GLS related to age, sex, and blood pressure. In contrast to GLS, cfPWV/GLS did not emerge as an independent predictor for CV events in the community.