ARTERIAL ELASTICITY AND HEART FUNCTION: A POPULATION STUDY IN SOUTHWESTERN SWEDEN

Objective: To investigate the associations between arterial elasticity and cardiac functions in a large representative observational study in Sweden. Design and method: Between 2002 and 2005, 2816 randomly selected individuals aged between 30 and 75, were examined (Men = 1400) to detect early signs of cardiometabolic disorders. In a substudy 1035 individuals of this cohort were invited to perform an echocardiography General Electrics VingMed S 5 System, operating with a 3.5 MHz-probe conducted by the same senior cardiologist. After excluding individuals without data on artery elasticity and cardiac functions, we included 991 (Men=488) individuals. Small artery elasticity (C2) was estimated using an applanations tonometer (Pulsewave CR-2000, Hypertension Diagnostics Inc.) over the arteria radialis. Linear regressions were used to investigate associations between standardized C2 and cardiac outcomes such as ejection fraction (EF) and cardiac index. We adjusted for age, heart rate, systolic blood pressure, LDL- cholesterol, stroke and acute myocardial infarction (AMI) in the medical history, presence of hypertension, body surface area, smoking, alcohol consumption and physical activity in different theoretical models. All analyses were stratified for sex. Results: The mean age was 50.7 years. Fifteen had AMI before inclusion and 14 had stroke in medical history. Hypertension was diagnosed in 184 individuals. There were significant differences between women and men in C2 and cardiac index (p<0.001); C2 (ml × mmHg-1 × 100) (SD): 7.6±3.5 for men, 6.2±3.3 for women; cardiac index (L/min/m2) (SD): 2.45±0.43 for men, 2.65±0.49 for women), but not in EF (%) (SD): 73.4 (±8.5) for men, 74.2 (±8.6) for women). In the fully adjusted model, an increase of one SD in C2 was associated with an increase in EF in both sexes (for men: beta: 0.14, 95% CI: 0.17- 2.24; p=0.026; for women: beta: 0.16, 95% CI: 0.42- 2.31; p=0.005). Furthermore, an increase of one SD in C2 was associated with increased cardiac index in men (beta: 0.15, 95% CI: 0.01- 0.12; p=0.021), but not in women (N.S.). Conclusions: Our findings demonstrate significant positive linear associations between small artery elasticity and systolic cardiac functions confirming the close interplay between vascular and cardiac function.