P1.03: Left Ventricular Remodeling: Impact of Global, Regional and Local Aortic Stiffness

Objectives Left ventricular (LV) concentric remodeling predicts all cause and CV mortality in various subsets of patients. Large arteries stiffness determines cardiac afterload and therefore LV remodeling. Since elastic properties of the arterial wall vary along the aortic pathway, we hypothesized that stiffness of consecutive aortic segments could have different impact on LV remodeling. Methods Global aortic stiffness was obtained from carotid-femoral pulse wave velocity (cfPWV, m/s) aplanation tonometry (Pulse Pen), and regional stiffness from aortic arch PWV phase contrast MRI. Local stiffness (m/s) was calculated in ascending (aaPWV) and descending aorta (daPWV) using cine MRI acquisition and surface change estimation (Bramwell-Hill equation). LV remodeling, MRI estimated, was expressed as LV mass over end diastolic volume ratio (M/V). Results We evaluated 146 patients (41+15 years old; 43.8% women) free of overt CV disease (hypertensives: 9.6%; smokers: 8.9%; diabetics: 0.6%; BMI: 23.8+3.5). In multivariate regression analysis cfPWV and aaPWV strongly correlated to M/V (partial R 2 =0.07, p=0.0011; and partial R 2 =0.10, p=0.0001, respectively), after adjustment for age, sex, BMI and brachial MBP. Challenged together, both cfPWV and aaPWV independently determined M/V, with 5% and 8% of explained variance, respectively. To a lower extent, daPWV (Partial R 2 = 0.04, p=0.0115) was also independently related to M/V. Arch PWV was not independently associated with M/V. Conclusions In this cross-sectional study, stiffness of diverse segments of the aorta had different influence on LV remodeling, except arch PWV. Stiffness of ascending aorta and the carotid-femoral pathway were complementary and also the strongest explanatory variables for LV remodeling.