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(Hypertension. 2007;49:317.)
© 2007 American Heart Association, Inc.

Original Articles

Age-Specific Relationship of Aortic Pulse Wave Velocity With Left Ventricular Geometry and Function in Hypertension

Giuseppe Schillaci; Massimo R. Mannarino; Giacomo Pucci; Matteo Pirro; Johny Helou; Gianluca Savarese; Gaetano Vaudo; Elmo Mannarino

From the Unit of Internal Medicine, Angiology and Arteriosclerosis, University of Perugia, Perugia, Italy.

Correspondence to Giuseppe Schillaci, Unit of Internal Medicine, Angiology and Arteriosclerosis, University of Perugia Medical School, Hospital "Santa Maria della Misericordia," Piazzale Menghini, 1, IT-06129 Perugia, Italy. E-mail skill{at}unipg.it

Aortic pulse wave velocity (PWV), generally considered an intrinsic marker of arterial stiffness, might depend in part on the velocity of myocardial fiber shortening, but the relation between PWV and myocardial function in humans has been understudied. A total of 237 untreated hypertensive subjects over a wide age range (18 to 88 years) underwent aortic PWV determination and echocardiography, from which the mean velocity of circumferential fiber shortening was calculated as a measure of the velocity of myocardial shortening, and relative wall thickness was taken as a measure of left ventricular concentric remodeling. Patients were divided in 3 age groups (<40 years, 40 to 59 years, and 60 years). In the young, aortic PWV was directly associated with heart rate–corrected velocity of circumferential fiber shortening (r=0.39; P=0.002) but not to relative wall thickness (r=–0.01; P=0.95). The opposite was found in the older group, in which aortic PWV was accompanied by a concentric left ventricular geometric pattern (r=0.44 with relative wall thickness; P=0.009) and a reduced velocity of circumferential fiber shortening (r=–0.54; P<0.001) and stress-corrected midwall fractional shortening (r=–0.56; P<0.001). Intermediate values were found in the middle-aged group (r=0.23; P<0.01 with relative wall thickness; r=–0.07, P value not significant with velocity of circumferential fiber shortening). In conclusion, the relation between aortic PVW and the left ventricle is strongly age dependent. These data suggest that, in young people, aortic PWV is partly determined by an increased velocity of myocardial shortening. With increasing age, a relationship between aortic PWV (as a measure of arterial stiffness) and left ventricular concentric geometry emerges, which ultimately leads to a depressed ventricular systolic function.

Key Words: pulse wave velocity • echocardiography • left ventricular function • hypertension • age • clinical science