Tohoku J. Exp. Med., 2011, 225(3)

Correlation of Arterial Stiffness to Left Ventricular Function in Patients with Reduced Ejection Fraction

SANAE NOGUCHI,¹ HISASHI MASUGATA,² SHOICHI SENDA,² KAORI ISHIKAWA,¹ HIROMI NAKAISHI,¹ AYU TADA,¹ TOSHIHIRO INAGE,¹ TATSUSHI KAJIKAWA,¹ MICHIO INUKAI,² TAKASHI HIMOTO,² NAOHISA HOSOMI,³ KAZUSHI MURAKAMI,⁴ TAKAHISA NOMA,⁴ MASAKAZU KOHNO,⁴ HIROKI OKADA,⁵ FUMINORI GODA² and KOJI MURAO⁶

¹Department of Clinical Laboratory, Kagawa University, Kagawa, Japan
²Department of Integrated Medicine, Kagawa University, Kagawa, Japan
³Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical Sciences, Hiroshima, Japan
⁴Department of Cardiorenal and Cerebrovascular Medicine, Kagawa University, Kagawa, Japan
⁵Department of Medical Education, Kagawa University, Kagawa, Japan
⁶Department of Advanced Medicine and Laboratory Medicine, Kagawa University, Kagawa, Japan

Heart failure has been divided into heart failure with preserved left ventricular (LV) ejection fraction (EF) and heart failure with reduced EF, because the pathophysiologies of the two conditions are different. Cardio-ankle vascular index (CAVI) is a new indicator of arterial stiffness, and the most conspicuous feature of CAVI is its independence of blood pressure at the time of measurement. Arterial stiffness has been considered to increase LV afterload, which requires special care to avoid the onset of heart failure. We compared the correlation of arterial stiffness as assessed by CAVI to LV function in 44 hypertensive patients with preserved EF (EF: 71 ± 7%) and 31 patients with reduced EF (48 ± 8%). All of patients with reduced EF had history of both hypertension and myocardial infarction. Using Doppler echocardiography, LV diastolic and systolic function was evaluated by measuring peak early diastolic mitral annular velocity (e') and global LV peak systolic longitudinal strain (GPSLS), respectively. In patients with preserved EF, CAVI was correlated with e' (r = −0.313, p = 0.038), but not with GPSLS (r = 0.207). By contrast, CAVI was correlated with GPSLS (r = 0.604, p < 0.001) as well as e' (r = −0.393, p = 0.029) in patients with reduced EF. Thus, patients with reduced EF showed a closer correlation of arterial stiffness to LV function compared with patients with preserved EF. Therefore, hypertensive patients with reduced EF require a stricter regimen for treating arterial stiffness than their counterparts with preserved EF.

keywords —— arterial stiffness; echocardiography; hypertension; left ventricular function; left ventricular ejection fraction

© 2011 Tohoku University Medical Press

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Tohoku J. Exp. Med., 2011, 225, 145-151

Correspondence: Hisashi Masugata, M.D., Ph.D., Department of Integrated Medicine, Kagawa University, 1750-1, Miki-cho, Kita-gun, Kagawa 761-0793, Japan.

e-mail: masugata@med.kagawa-u.ac.jp