Association between central aortic pressure and diastolic function in patients undergoing coronary angiography

Background. Aortic pressure dynamics significantly affect the development of arteriosclerosis, and chronic changes in the aortic wall, including surface stiffness, are strongly associated with cardiovascular mortality and morbidity. Variations in central aortic pressure and its derivatives have an impact on myocardial structural remodeling and function.

This study aimed to determine the associations between invasively measured central aortic pressure and its derivatives and between left ventricular (LV) diastolic function status and torsion.

Design and methods. This prospective study included 90 participants with normal LV function who were referred for elective coronary angiography.

Results. There was a significant linear correlation between echocardiographic parameters reflecting LV diastolic function, such as the left atrial volume index (LAVI), the LV E/еʼ (ratio between mitral early diastolic velocity and early diastolic tissue annular velocity), and central aortic pressure. LV twist did not correlate with central aortic pressure parameters. Only 15 patients out of 90 had LV diastolic dysfunction of grade 2 and above, with a mean LV twist of 19,65 ± 9,4 vs 16,70 ± 8,6 degrees, as determined by normal LV end-diastolic pressure (p = 0,206). This difference appears clinically significant, illustrating that the increase in LV twist is predominant in patients with higher grades of LV diastolic dysfunction, irrespective of LV mass.

Conclusion. There was a relationship and interaction between central aortic pressure and LV diastolic function status. Despite all participants had normal LV ejection fraction, LV twist appeared to be increased among the patients with LV diastolic dysfunction of grade 2 or above.

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