Interrelations of aortic spring function, cardiovascular disease risk factors, and left ventricular diastolic function: The Framingham Heart Study

Abstract Background Energy associated with proximal aortic stretch during systole is recovered as diastolic elastic recoil of the aorta that facilitates left ventricular filling. Impairment of this aortic spring mechanism may contribute to left ventricular diastolic dysfunction. However, cross-sectional and longitudinal inter-relations of cardiovascular disease risk factors, aortic stretch, and left ventricular diastolic function have not been examined. The goal of this study was to assess the cross-sectional and longitudinal associations of cardiovascular disease risk factors and systolic atrioventricular plane displacement (AVPD), a surrogate measure of stretch of the mechanically coupled ascending aorta, with measures of left ventricular diastolic function. Methods At two examinations (14±1 years apart) in Framingham Heart Study participants (N=7117; mean age 50 years, 55% women), we assessed AVPD and left ventricular diastolic function using echocardiography. We measured systolic AVPD using the integral of the tissue Doppler s’ wave. Additionally, we assessed e’ (the peak early diastolic tissue velocity of the lateral mitral annulus) and E/e’ (the ratio of peak early mitral inflow velocity and e’). Results In cross-sectional analyses, higher AVPD was associated with higher e’ ( β per SD±standard error=0.43±0.01; P