Introduction: a relation between aortic stiffening (AS) and LV systolic dysfunction and hypertrophy is established in the elderly. A relation between AS and LV diastolic function can be hypothesized, mediated by age and increased LV mass (LVM).

Aim: to verify whether AS may affect LV diastolic function independently of LVM and age in subjects with preserved systolic function.

Methods: 144 subjects below 65 years, (59 controls: age 40±12, MBP 84±7 mmHg; and 85 patients with at least one major risk factor, free of CV disease, age 42±16, mean BP 96±12 mmHg). LV mass, systolic function, diastolic filling were assessed by Echo-Doppler. Early and late diastolic mitral annulus longitudinal velocities (E’ and A’) were assessed by tissue velocity imaging. AS was estimated by carotid-femoral pulse wave velocity (PWV).

Results: compared to controls, patients had higher (p<0.05–0.001) PWV (9.4±2 vs 8.0±1 m/s) and lower transmitral E/A ratio (1.2±0.5 vs 1.4±0.4, p<0.01); no significant differences were found for LV midwall shortening (116±13 and 119±13 %), and EF (67±6 and 69±5 %). In the overall population, transmitral E/A correlated inversely (p< 0.01) with age (r=−0.60), SBP (r=−0.37), DBP (r=−0.50), LVMI (r=−0.43), and PWV (r=−0.51). In multivariate analysis, PWV remained independent predictor of E/A, together with age, SBP and DBP (adjusted R² 0.43, p < 0.05). E’/A’ showed a similar correlation pattern as E/A.

Conclusion: in subjects free of CV disease and with preserved LV systolic function, AS affects LV diastolic filling and longitudinal myocardial velocities independently of age, LVM and BP.