Aim: . To evaluate the relationship between left ventricular (LV) diastolic and systolic function, arterial stiffness and endothelial function in patients with dilated cardiomyopathy (DCM)

Methods: In 54 patients with DCM (age 63±13 years, 10 females) and LV ejection fraction (EF)<45%, applanation tonometry (Sphygmocor®) was evaluated for determining augmentation index (AIx) and pulse pressure (PP) amplification (brachial PP / central PP%) by pulse wave analysis and carotid to femoral pulse wave velocity (PWV). Endothelium-dependent (flow-mediated dilation, FMD, after 5-minute of forearm ischemia) and independent (sublingual glycerol trinitrate, GTN, 25 μg) vasodilation were assessed by ultrasounds and computerized analysis of brachial artery diameter changes. A Doppler and echocardiographic study was also performed, for measurements of E/A ratio and E wave deceleration time (ETD).

Results: . Mean LV EF was 32±10%. AIx was related to E/A ratio (r=–0.51; p<0.01) and EDT (r=0.36; p<0.05). PP amplification correlated with E/A ratio (r=0.61; p<0.0001) and EDT (r=–0.36; p<0.05). PWV was associated with EDT (r=0.36; p<0.05). A significant correlation was found between PP amplification and LV EF (r=–0.33; p<0.05). No significant correlations were apparent between FMD, response to GTN and FMD/GTN ratio with respect to indexes of LV systolic and diastolic function.

Conclusions: In DCM patients, arterial stiffness is related to LV diastolic dysfunction, indicating that increased arterial stiffness is associated with either restrictive or pseudo-normal LV filling. Pulse wave amplification is directly related to diastolic parameters and inversely to systolic function, suggesting lesser central pressure augmentation rather than increased peripheral amplification.