Association between high arterial stiffness and left ventricular filling pressures in patients with acute myocardial infarction

Abstract

Introduction High arterial stiffness increases the left ventricular (LV) filling pressures in different cardiac disorders. The association between arterial stiffness and LV filling pressures has not been studied so far in patients with acute myocardial infarction (MI). Objectives The aim of the study was to assess the association between arterial stiffness and LV filling pressures in patients with acute MI. Patients and methods Arterial stiffness, measured using the digital volume pulse stiffness index (SIDVP), and LV filling pressures, quantified as the ratio of early transmitral flow velocity to early diastolic septal mitral annulus velocity (E/e'), were evaluated in 263 patients with acute MI (mean age, 63.8 ±11 years; 69 women). The association between high E/e' (>15) and very stiff arteries (SIDVP >18 m/s) was analyzed by logistic regression, with data presented as odds ratios (OR s) and 95% confidence intervals (CIs). Results A multivariate logistic regression analysis revealed an association between E/e' >15 and SIDVP >18 m/s (OR, 4.7; 95% CI, 1.8-12.3), independently of female sex (OR, 4.3; 95% CI, 1.4-10.2), LV ejection fraction <35% (OR, 3.1; 95% CI, 1.2-8.2), left atrial volume >34 ml/m2 (OR, 17.4; 95% CI, 5.8-52.0). There was no significant association between E/e' >15 and previ ous MI (OR, 2.2; 95% CI, 0.9-5.7). Conclusions High arterial stiffness is an independent risk factor for LV diastolic dysfunction in patients with acute MI. A reduction in arterial stiffness may improve LV diastolic function in this patient group. Copyright by Medycyna Praktyczna Kraków 2015.