388 Normal vascular aging evaluated by a new tool: e-tracking

TLDR: In otherwise healthy subjects from lean to morbid obesity, visceral adiposity is associated with increase in CO, BP and carotid stiff- ness and WI analysis, but not established indices of LV performance, discloses an unfavorable VA coupling in obesity.

Abstract: ; BP 126±15/76±10 mm Hg), free of heart disease, HBP, diabetes, dyslipidemia were studied. LV pump function (CO and EF) was assessed by 2D Echo. Arterial mechanics was evaluated at carotid level by vascular ultra- sound (Aloka SSD-5500) implemented with a double beam tracking system providing distension waveforms, diameter-derived pressure and flow. Pres- sure independent stiffness index (s) and pulse wave velocity (PWV) were estimated. By wave intensity analysis (time-dependent product of first de- rivatives of BP and flow), an index of LV inotropic function was obtained by the amplitude of the early-systolic peak (forward compression wave, FCW). Insulin sensitivity was estimated from plasma glucose and insulin responses to O-GTT (OGIS index). Results: Waist to hip ratio (W/H) correlated directly with MBP, CO, PWV, b (r: 0.34-0.41, p<0.01), but not with EF and FCW. OGIS correlated inversely with W/H, CO, MBP (r: -0.45 to -0.47, p<0.005) but not with stiffness. PWV and s correlated directly with age and MBP (r: 0.35-0.63), but not with OGIS. In a sex-adjusted multivariate model, age and MBP were independent pre- dictors of stiffness (adjusted r2: 0.57). Both PWV and s were inversely re- lated to FCW (r: -0.27 for both, p<0.05), but not to CO and EF. Conclusions: In otherwise healthy subjects from lean to morbid obesity, visceral adiposity is associated with increase in CO, BP and carotid stiff- ness. Visceral adiposity and changes in systemic hemodynamics are asso- ciated with IR. Increased carotid stiffness paralleling visceral adiposity re- sults from increased BP more than from an independent effect of IR. WI analysis, but not established indices of LV performance, discloses an unfavorable VA coupling in obesity.