Background: Arterial hypertension is associated with accelerated atherosclerosis resulting in increased arterial stiffness. It is well known that left ventricular (LV) diastolic dysfunction is prerequisite condition of heart failure in hypertensive patients with or without LV hypertrophy. This study aims to determine the relationship between arterial stiffness and LV diastolic dysfunction in never treated hypertensive patients with preserved LV ejection fraction (EF). Methods: We performed a cross-sectional study including total 123 patients (54±12 years, 54 male) with hypertension who never treated or discontinued medication for at least 6 months. LV systolic and diastolic function was assessed with transthoracic echocardiography and asymptomatic atherosclerosis was also determined by measuring brachial-ankle pulse wave velocity (baPWV). Results: Mean systolic BP was 151±15 mmHg and percentage of daytime BP more than 135 mmHg was 59% in 24 hour ambulatory BP monitoring. Mean baPWV was 1574.3±283.2 cm/sec. There was no evidence of LV systolic (mean EF=63±7%) or diastolic (E/A=1.0±0.3, deceleration time of mitral early inflow=196.1±50.0 msec) dysfunction. LV filling pressure was in normal range (mean E/E’=10.0±3.5) and mean value of LV mass index was 102.4±28.9 g/m2 in men and 99.4±23.8 g/m2 in women. However, baPWV was significantly correlated with LV stretching velocity during early diastolic phase (r=0.636, P<0.001), LV filling pressure (r=0.338, P=0.009) and systolic BP (r=0.438, P<0.001). Age was also significantly correlated with baPWV (r=0.427, P<0.001). On regression analysis, averaged systolic BP during 24 hours and LV stretching velocity during early diastolic phase was independently related with baPWV (r2=0.499, P=0.035 and 0.007 respectively). Conclusion: Our data confirms the positive correlation between arterial stiffness and LV diastolic stretching motion in never treated and non-complicated hypertension. This means LV diastolic dysfunction develops in early stage of hypertension. Non-invasive measurement of LV diastolic motion might be useful for monitoring the treatment efficacy to prevent LV hypertrophy or heart failure.
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