Relations between aortic stiffness and left ventricular mechanical function in the community

Background--aortic stiffness impairs optimal ventricular-vascular coupling and left ventricular systolic function,particularly in the long axis. left ventricular global longitudinal strain (gls) has recently emerged as a sensitive measure of early cardiac dysfunction. in this study,we investigated the relation between aortic stiffness and gls in a large community-based sample. methods and results--in 2495 participants (age 39-90 years,57% women) of the framingham offspring and omni cohorts,free of cardiovascular disease,we performed tonometry to measure arterial hemodynamics and echocardiography to assess cardiac function. aortic stiffness was evaluated as carotid-femoral pulse wave velocity and as characteristic impedance,and gls was calculated using speckle tracking-based measurements. in multivariable analyses adjusting for age,sex,height,systolic blood pressure,augmentation index,left ventricular structure,and additional cardiovascular risk factors,increased carotid-femoral pulse wave velocity (b±se: 0.122±0.030% strain per sd,p < 0.0001) and characteristic impedance (0.090±0.029,p=0.002) were both associated with worse gls. we observed effect modification by sex on the relation between characteristic impedance and gls (p=0.004); in sex-stratified multivariable analyses,the relation between greater characteristic impedance and worse gls persisted in women (0.145±0.039,p=0.0003) but not in men (p=0.73). conclusions--multiple measures of increased aortic stiffness were cross-sectionally associated with worse gls after adjusting for hemodynamic variables. parallel reductions in left ventricular long axis shortening and proximal aortic longitudinal strain in individuals with a stiffened proximal aorta,from direct mechanical ventricular-vascular coupling,offers an alternative explanation for the observed relations. © 2017 the authors.