| Abstract [eng] |
Objective. To evaluate the relationship between arterial stiffness and left ventricular diastolic dysfunction(LVDD) in metabolic syndrome(MetS) patients. Methods. The cross-sectional study was carried among 1208 MetS subjects (64,8% men, 93,3% hypertensive). 573 subjects were evaluated after 3,8±0,6yr. Arterial stiffness was assessed by applanation tonometry. LVDD was defined according to the 2016 ESC Guidelines for the diagnosis and treatment of heart failure. Results. Subjects with LVDD (75,7%) were older (54,7±6vs 52±6yr), had higher cfPWV (9,0±1,6vs 8,2±1,3 m/s), AIxHR75 (25,4±9,9vs 21,1±10,8 %), mean arterial pressure(mAP) (108,6±12,8vs 103,4±10,1mmHg), HR (66,4±9,4vs 63,8±8,2 bpm), LV mass index(LVMI) (109,8±24vs 101,9±21,5 g/m2) all p<0.05. We found significant correlations between arterial stiffness and E/A (rcfPWV=-0,19, rAIxHR75=-0,15), e' (rcfPWV=-0,25, rAIxHR75=-0,18), E/e' (rcfPWV=0,17, rAIxHR75=0,14, all p<0,05). In multiple regression analysis cfPWV, gender, mAP, LVMI, HR, BMI remained significant determinants of E/e' (p<0,05). During the observation LV diastolic function didn’t change in 337, deteriorated in 110 and improved in 126 participants. We found significant alterations of arterial and diastolic function parameters(mean): cfPWV 8,55±1,4vs 8,7±1,6m/s; Aix/HR75 22,8±10,4vs 24,3±10,8%; mAP 105,3±10,4vs 101,5±14,8mmHg; LVMI 105±22,7vs 99±24,1 (all p<0,05). To clarify the relation between LVDD and arterial stiffness the conditional inference trees analysis was used. Only cfPWV, mAP, HR and BMI remained significant for presence of LVDD. Conslusion. Arterial stiffness is significant determinant of LV diastolic dysfunction and can be a possible causal link to development of left ventricular diastolic dysfunction. |
