Cardiovascular risk factors and systolic and diastolic cardiac function: a tissue Doppler and speckle tracking echocardiographic study.

Background: The aim of this study was to determine whether blood pressure, body mass index (BMI), serum lipids, glucose, and renal function are associated with left ventricular (LV) and right ventricular function in a low-risk population.

Methods: The associations of common risk factors with cardiac function were assessed, using multiple linear regression, in a random sample of 1,266 individuals free from hypertension, diabetes, and cardiovascular disease. A combination of conventional echocardiographic, speckle-tracking, and tissue Doppler methods was used to assess cardiac function.

Results: Older age and higher BMI, systolic and diastolic blood pressure, and non-high-density lipoprotein (HDL) cholesterol were associated with lower LV function. Thus, LV strain was reduced by approximately 5% per 5 kg/m(2) increase in BMI and by 4% per 10 mm Hg increase in diastolic blood pressure. Corresponding reductions in peak early diastolic mitral annular velocity were 7% for both BMI and diastolic blood pressure. Higher HDL cholesterol was associated with better LV function. In women, smoking was also associated with reduced LV function. LV function was lower also at low levels of diastolic pressure and BMI. Reduced right ventricular function was related to older age, smoking, higher diastolic blood pressure and non-HDL cholesterol, and lower HDL cholesterol.

Conclusions: These findings suggest that conventional risk factors may predict cardiac function many years before clinical disease. The J-shaped associations related to diastolic blood pressure and BMI may suggest that in some individuals, low levels of these factors may indicate underlying but unknown disease.