Studies investigating the association between central aortic pressures and diastolic function have been limited.
Consecutive ambulatory patients (n=281, mean age 49±13 yrs, 49% male) with normal LV systolic function were included. LV filling pressure (E/Em) was estimated by Doppler-derived ratio of mitral inflow velocity [E] to septal [Em] by tissue Doppler, LV relaxation by Em, central aortic pressures by radial tonometry. Central aortic systolic (cSBP), diastolic (cDBP), mean (cMAP), and pulse pressure (cPP) were entered individually into stepwise linear regression models to determine their association with E/Em or Em.
In univariate analysis, cPP correlated most strongly with E/Em (Spearman’s rho=0.45, p<0.001), while cSBP correlated most strongly with Em (Spearman’s rho=−0.51, p<0.001). Multivariate analysis demonstrated that the pulsatile component of afterload, cPP, contributed most to E/Em (partial r2=23%); meanwhile the nonpulsatile components (cDBP and cMAP), were significant but small contributors (partial r2 of 6% and 5% respectively) of LV relaxation (Em).
The nonpulsatile components of aortic afterload (central mean aortic pressure (cMAP) and central aortic diastolic blood pressure cDBP), exhibited a weak but significant association with LV relaxation, while the pulsatile component of afterload, central aortic pulse pressure (cPP), exhibited strong association with LV filling pressure.