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Re: Aortic mechanical properties and left ventricular diastolic functions

Dear editor

I read with great interest the recently published study by Eren et al. [1]

They reported that increased aortic stiffness in patients with hypertension, diabetes mellitus, and both caused to impaired left ventricular (LV) diastolic functions. Furthermore, they also found that there was a relation between the diastolic function and aortic stiffness in the patients. It is known that the aorta is not a simple conduit for the distribution of blood but rather has a fundamental role in the function of the cardiovascular system. By virtue of its elastic properties, aorta influences LV function and coronary blood flow. [2] Although they excluded of coronary artery disease, it is convinced that changes of myocardial tissue properties (intrinsic factors) affect LV diastolic functions especially in patients with diabetes. On the other hand, it is strikes me that decreased aortic distensibility and increased aortic stiffness in pathologic conditions may facilitate to be upset the diastolic functions like as a promoter factor.

What is more, with reference to our study, according to different aspect aortic elastic properties are changed as a result of regular exercise. [3-5] While aortic stiffness is decreased in endurance-trained athletes [3], on the contrary, it is decreased in strength-trained athletes [4]. However, in athletes who train both types of exercise, diastolic functions of LV are better than those of sedentary subjects. In the same way, we also found that multivariate analyses showed a strong correlation between aortic distensibility and LV diastolic functions (measured by standard and tissue Doppler echocardiography). [5]

Taking all studies into consideration, although the exact association between aortic mechanical function parameters and LV diastolic properties is not known, we conclude that aortic stiffness is one of the afterload factors which may affect LV diastolic performance in disease, damaged of physiological situation.

References

1. Eren M, Gorgulu S, Uslu N, Celik S, Dagdeviren B, Tezel T. Relation between aortic stiffness and left ventricular diastolic function in patients with hypertension, diabetes, or both. Heart 2004;90:37-43.

2. Stefanadis C, Stratos C, Vlachopoulos C, et al. Pressure-diameter relation of the human aorta: a new method of determination by the application of a special ultrasonic dimension catheter. Circulation 1995;92:2210-2219.

3. Kasikcioglu E, Oflaz H, Akhan H, et al. Aortic distensibility in endurance athletes. Acta Cardiologica 2003;58:243-4.

4. Kasikcioglu E, Oflaz H, Akhan H, et al. Left ventricular remodeling and aortic distensibility in elite power athletes. Heart Vessels 2004;(in press).