Arterial wave reflection and subclinical left ventricular systolic dysfunction

Cesare Russo, Zhezhen Jin, Yasuyoshi Takei, Takuya Hasegawa, Shun Koshaka, Vittorio Palmieri, Mitchell S V Elkind, Shunichi Homma, Ralph L Sacco, Marco R. Di Tullio

Research output: Contribution to journalArticle

23 Citations (Scopus)


Objectives: Increased arterial wave reflection is a predictor of cardiovascular events and has been hypothesized to be a cofactor in the pathophysiology of heart failure. Whether increased wave reflection is inversely associated with left-ventricular (LV) systolic function in individuals without heart failure is not clear. Methods: Arterial wave reflection and LV systolic function were assessed in 301 participants from the Cardiovascular Abnormalities and Brain Lesions (CABL) study using two-dimensional echocardiography and applanation tonometry of the radial artery to derive central arterial waveform by a validated transfer function. Aortic augmentation index (AIx) and wasted energy index (WEi) were used as indices of wave reflection. LV systolic function was measured by LV ejection fraction (LVEF) and tissue Doppler imaging (TDI). Mitral annulus peak systolic velocity (Sm), peak longitudinal strain and strain rate were measured. Participants with history of coronary artery disease, atrial fibrillation, LVEF less than 50% or wall motion abnormalities were excluded. Results: Mean age of the study population was 68.3 ± 10.2 years (64.1% women, 65% hypertensive). LV systolic function by TDI was lower with increasing wave reflection, whereas LVEF was not. In multivariate analysis, TDI parameters of LV longitudinal systolic function were significantly and inversely correlated to AIx and WEi (P values from 0.05 to 0.002). Conclusions: In a community cohort without heart failure and with normal LVEF, an increased arterial wave reflection was associated with subclinical reduction in LV systolic function assessed by novel TDI techniques. Further studies are needed to investigate the prognostic implications of this relationship.

Original languageEnglish
Pages (from-to)574-582
Number of pages9
JournalJournal of Hypertension
Issue number3
StatePublished - Mar 1 2011


Left Ventricular Dysfunction
Left Ventricular Function
Heart Failure
Cardiovascular Abnormalities
Radial Artery
Stroke Volume
Atrial Fibrillation
Coronary Artery Disease
Multivariate Analysis


  • arterial stiffness
  • echocardiography
  • strain
  • strain rate
  • systolic function
  • tissue Doppler
  • wave reflection

ASJC Scopus subject areas

  • Internal Medicine
  • Physiology
  • Cardiology and Cardiovascular Medicine

Cite this

Russo, C., Jin, Z., Takei, Y., Hasegawa, T., Koshaka, S., Palmieri, V., ... Di Tullio, M. R. (2011). Arterial wave reflection and subclinical left ventricular systolic dysfunction. Journal of Hypertension, 29(3), 574-582.

Arterial wave reflection and subclinical left ventricular systolic dysfunction. / Russo, Cesare; Jin, Zhezhen; Takei, Yasuyoshi; Hasegawa, Takuya; Koshaka, Shun; Palmieri, Vittorio; Elkind, Mitchell S V; Homma, Shunichi; Sacco, Ralph L; Di Tullio, Marco R.

In: Journal of Hypertension, Vol. 29, No. 3, 01.03.2011, p. 574-582.

Research output: Contribution to journalArticle

Russo, C, Jin, Z, Takei, Y, Hasegawa, T, Koshaka, S, Palmieri, V, Elkind, MSV, Homma, S, Sacco, RL & Di Tullio, MR 2011, 'Arterial wave reflection and subclinical left ventricular systolic dysfunction', Journal of Hypertension, vol. 29, no. 3, pp. 574-582.
Russo, Cesare ; Jin, Zhezhen ; Takei, Yasuyoshi ; Hasegawa, Takuya ; Koshaka, Shun ; Palmieri, Vittorio ; Elkind, Mitchell S V ; Homma, Shunichi ; Sacco, Ralph L ; Di Tullio, Marco R. / Arterial wave reflection and subclinical left ventricular systolic dysfunction. In: Journal of Hypertension. 2011 ; Vol. 29, No. 3. pp. 574-582.
title = "Arterial wave reflection and subclinical left ventricular systolic dysfunction",
abstract = "Lippincott Williams & Wilkins.",
keywords = "arterial stiffness, echocardiography, strain, strain rate, systolic function, tissue Doppler, wave reflection",
author = "Cesare Russo and Zhezhen Jin and Yasuyoshi Takei and Takuya Hasegawa and Shun Koshaka and Vittorio Palmieri and Elkind, {Mitchell S V} and Shunichi Homma and Sacco, {Ralph L} and {Di Tullio}, {Marco R.}",
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issn = "0263-6352",
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T1 - Arterial wave reflection and subclinical left ventricular systolic dysfunction

AU - Russo, Cesare

AU - Jin, Zhezhen

AU - Takei, Yasuyoshi

AU - Hasegawa, Takuya

AU - Koshaka, Shun

AU - Palmieri, Vittorio

AU - Elkind, Mitchell S V

AU - Homma, Shunichi

AU - Sacco, Ralph L

AU - Di Tullio, Marco R.

PY - 2011/3/1

Y1 - 2011/3/1

N2 - Lippincott Williams & Wilkins.

AB - Lippincott Williams & Wilkins.

KW - arterial stiffness

KW - echocardiography

KW - strain

KW - strain rate

KW - systolic function

KW - tissue Doppler

KW - wave reflection

UR -

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U2 - 10.1097/HJH.0b013e328342ca56

DO - 10.1097/HJH.0b013e328342ca56

M3 - Article

C2 - 21169863

AN - SCOPUS:79951680090

VL - 29

SP - 574

EP - 582

JO - Journal of Hypertension

JF - Journal of Hypertension

SN - 0263-6352

IS - 3

ER -