Objectives We assessed to what extent arterial properties measured at baseline and follow-up predict longitudinal alterations in echocardiographic indexes reflecting left ventricular (LV) structure and function.

Background Serial imaging studies are needed to clarify the relation of changes in LV structure and function to arterial stiffness.

Methods In 607 participants (50.7% women; mean age 50.7 years), using echocardiography and Doppler imaging, we measured LV dimensions, transmitral blood flow, and mitral annular tissue velocities at baseline and after 4.7 years. Using applanation tonometry, we assessed central pulse pressure (cPP) and carotid-femoral pulse wave velocity (PWV) at baseline. We regressed longitudinal changes in LV indexes on the arterial stiffness parameters and reported standardized effect sizes as a fraction of SD of LV change.

Results After full adjustment, longitudinal increase in LV septal (standardized effect size: +14.4%; p = 0.0018) and posterior wall (+12.6%; p = 0.0027) thickness was associated with higher baseline PWV, whereas LV internal diameter (-12.4%; p = 0.012) decreased during follow-up with PWV. Consequently, greater increase in relative wall thickness was associated with higher baseline PWV (+17.2%; p <0.0001). Participants with higher baseline PWV had a greater risk to develop or retain LV concentric remodeling during follow-up (odds ratio 1.35; p = 0.028). In addition, in women, baseline cPP predicted a greater increase in LV mass (+22.8%; p = 0.0009) and E/e′ ratio (+36.1%; p <0.0001).

Conclusions Progression to LV concentric remodeling pattern was associated with higher baseline PWV. In women, cPP predicted worsening of LV diastolic function. Our study highlights the importance of arterial properties as mediator of LV concentric remodeling in men and women, and diastolic dysfunction in women.

目的我们评估了在基线和随访时测得的动脉特性在多大程度上可预测超声心动图指数的纵向变化，反映出左心室（LV）的结构和功能。

背景技术需要进行串行影像学研究来阐明左室结构和功能的变化与动脉僵硬度之间的关系。

方法在607名参与者（50.7％的女性；平均年龄50.7岁）中，通过超声心动图和多普勒成像技术，我们测量了基线和4.7年后的LV尺寸，透射血流和二尖瓣环组织速度。使用压平眼压计，我们评估了基线时的中心脉压（cPP）和颈动脉股脉波速度（PWV）。我们对动脉僵硬度参数的LV指数的纵向变化进行了回归分析，并报告了标准化效应量，作为LV变化SD的一部分。

结果完全调整后，左室间隔（标准效应值：+ 14.4％； p = 0.0018）和后壁（+ 12.6％； p = 0.0027）厚度的纵向增加与较高的基线PWV相关，而左室内径（-12.4） ％； p = 0.012）在PWV随访期间降低。因此，相对壁厚的更大增加与更高的基线PWV相关（+ 17.2％； p <0.0001）。基线PWV较高的参与者在随访期间发生或保留LV同心重塑的风险更大（优势比1.35； p = 0.028）。此外，在女性中，基线cPP预测左室重量（+ 22.8％； p = 0.0009）和E / e'比（+ 36.1％； p <0.0001）有更大的增加。

结论LV同心重塑模式的进展与基线PWV升高有关。在女性中，cPP预测左心室舒张功能恶化。我们的研究突出了动脉特性作为男性和女性左心室同心重塑以及女性舒张功能障碍的中介的重要性。