HEART VESSEL COUPLING IN SUBJECT WITH RISK FACTORS: A LONGITUDINAL LEFT VENTRICULAR FUNCTION AND ARTERIAL STIFFNESS STUDY

Abstract Aims To assess the carotid mechanical properties in patients with hypertrophic cardiomyopathy and the relation between arterial stiffness and left ventricular function in this setting. Methods and results We have prospectively enrolled 71 patients (52 ± 16 years, 34 men) with hypertrophic cardiomyopathy, divided into two groups depending on the presence (46 patients) or absence (25 patients) of cardiovascular risk factors associated with increased arterial stiffness. Twenty-five normal subjects similar by age and gender with hypertrophic cardiomyopathy patients without risk factors formed the control group. A comprehensive echocardiography was performed in all subjects. Carotid arterial stiffness index (β index), pressure–strain elastic modulus, arterial compliance, and pulse wave velocity were also obtained using an echo-tracking system. β index, pulse wave velocity, and pressure–strain elastic modulus were significantly higher in hypertrophic cardiomyopathy patients without risk factors compared to controls. After linear regression analysis, the increase in carotid β index was independently correlated with the presence of hypertrophic cardiomyopathy [beta = 0.49, 95% confidence interval (CI) = 1.04–3.02; P < 0.001]. In the entire hypertrophic cardiomyopathy population arterial stiffness parameters correlated with age, gender, hypertension degree, presence of hypercholesterolaemia, and the E/e′ ratio. In multivariable analysis, β index (beta = 0.36, 95% CI = 0.32–1.25; P = 0.001), global left ventricular longitudinal strain, and the presence of left ventricular outflow tract obstruction were independently correlated with the E/e′ ratio. Conclusion In patients with hypertrophic cardiomyopathy arterial stiffness is increased independently of age or presence of cardiovascular risk factors. Carotid artery stiffness is independently related to left ventricular filling pressure, increased arterial stiffness representing a possible marker of a more severe phenotype.

Download Full-text

Endovascular treatment of peripheral artery disease is associated with improved central hemodynamics and ventricular function

European Heart Journal ◽

10.1093/ehjci/ehaa946.2381 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

D Messiha ◽

L Halfmann ◽

O Azizy ◽

M Steinmetz ◽

T Rassaf ◽

...

Keyword(s):

Arterial Stiffness ◽

Left Ventricular Function ◽

Endovascular Treatment ◽

Ventricular Function ◽

Peripheral Artery Disease ◽

Cardiovascular Mortality ◽

Left Ventricular ◽

Central Hemodynamics ◽

Peripheral Artery ◽

Artery Disease

Abstract Background Peripheral artery disease (PAD) is a major manifestation of atherosclerosis and a risk factor for morbidity and mortality. PAD itself is associated with increased arterial stiffness with impact on cardiac functions. Previous studies have demonstrated that augmentation index (AIx) and central blood pressure (CBP) correlate with increased cardiovascular mortality. This mechanism has been described as arterio-ventricular (AV) coupling with altered ventricular afterload and a depressed ventricular function, measured by global longitudinal strain (GLS). The impact of PAD-related endovascular treatment on arterial stiffness, central hemodynamics and potential impact on AV coupling has not been elucidated until now. Purpose Aim of the study was to investigate, if endovascular treatment of PAD improves cardiac function via enhanced central hemodynamics and AV coupling. Methods To this aim 77 patients with known symptomatic PAD who underwent interventions in the iliac and femoropopliteal arteries were included in a cross-sectional study. AIx, CBP and GLS were determined using dedicated waveform analysis and echocardiography before and after endovascular treatment. Results Mean age was 65.1±10.4 years with 66.2% male patients. Symptoms were classified by Fontaine classification (stage IIb 80.7%, stage III 5.8% and stage IV 13.5%). Iliac vessel intervention was performed in 16 and femoropopliteal intervention in 61 cases. A stentless approach was feasible in 55 patients with DCB treatment and atherectomy. After endovascular treatment, peripheral perfusion was enhanced (ABI 0.45±0.6 vs 0.81±0.5, p<0.0001). Moreover, central hemodynamics were improved (AIX 33.7±3% vs 27.9±2%, p=0.0008; AP 17.8±2 mmHg vs 14.0±2 mmHg, p=0.0004; central PP 52.4±6 mmHg vs 46.4±6 mmHg, p=0.0001). Impressively, left ventricular function was also significantly improved (GLS −15.7±2.3% vs −17.1±2.8%, p=0.005) with an improvement in AV coupling (PWV/GLS ratio −0.58m/sec% vs −0.56m/sec%, p<0.01). Conclusion Our results demonstrate that endovascular treatment of the peripheral vessels is associated with an improvement of central hemodynamics and left ventricular function via enhanced AV coupling. These prognostic relevant markers of cardiovascular disease could point to an overall potential mortality benefit through PAD treatment. Further investigation of the underlying mechanisms of AV coupling in the setting of endovascular treatment of PAD with impact on cardiovascular mortality is needed in this high-risk population. Funding Acknowledgement Type of funding source: None

Download Full-text

ACUTE EFFECT OF ATI RECEPTOR BLOCKER TELMISARTAN ON ARTERIAL STIFFNESS AND LEFT VENTRICULAR FUNCTION

Journal of Hypertension ◽

10.1097/00004872-200402001-00084 ◽

2004 ◽

Vol 22 (Suppl. 1) ◽

pp. S24

Author(s):

Antonio Delgado Leon ◽

S Celis Carrero ◽

A Delgado Almeida ◽

C Delgado Leon

Keyword(s):

Arterial Stiffness ◽

Left Ventricular Function ◽

Ventricular Function ◽

Acute Effect ◽

Left Ventricular ◽

Receptor Blocker

Download Full-text

RISK FACTORS OF SELF-TERMINATING AND PERPETUATING VENTRICULAR TACHYARRHYTHMIAS IN POST-INFARCTION PATIENTS WITH MODERATELY DEPRESSED LEFT VENTRICULAR FUNCTION, A CARISMA SUB-ANALYSIS

Journal of the American College of Cardiology ◽

10.1016/s0735-1097(10)60066-6 ◽

2010 ◽

Vol 55 (10) ◽

pp. A7.E65

Author(s):

Juha Perkiomaki ◽

Poul-Erik Bloch Thomsen ◽

Marc Messier ◽

Heikki Huikuri

Keyword(s):

Risk Factors ◽

Left Ventricular Function ◽

Ventricular Function ◽

Left Ventricular ◽

Ventricular Tachyarrhythmias ◽

Depressed Left Ventricular Function

Download Full-text

Assessment of risk factors and left ventricular function in patients with slow coronary flow

Heart and Vessels ◽

10.1007/s00380-014-0606-4 ◽

2014 ◽

Vol 31 (3) ◽

pp. 288-297 ◽

Cited By ~ 8

Author(s):

Yuling Li ◽

Yonghuai Wang ◽

Dalin Jia ◽

Yan Lv ◽

Yan Zhang ◽

...

Keyword(s):

Risk Factors ◽

Left Ventricular Function ◽

Ventricular Function ◽

Coronary Flow ◽

Left Ventricular ◽

Slow Coronary Flow

Download Full-text

Evaluation of the Effect of Cardiac Rehabilitation on Left Atrial and Left Ventricular Function and Its Relationship with Changes in Arterial Stiffness in Patients with Acute Myocardial Infarction

Echocardiography ◽

10.1111/echo.12701 ◽

2014 ◽

Vol 32 (3) ◽

pp. 443-447 ◽

Cited By ~ 8

Author(s):

Rezzan Deniz Acar ◽

Mustafa Bulut ◽

Sunay Ergün ◽

Mahmut Yesin ◽

Mustafa Akçakoyun

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Arterial Stiffness ◽

Left Ventricular Function ◽

Cardiac Rehabilitation ◽

Ventricular Function ◽

Left Atrial ◽

Left Ventricular

Download Full-text

Lack of association of a 9 bp insertion/deletion polymorphism within the bradykinin 2 receptor gene with myocardial infarction

Clinical Science ◽

10.1042/cs20040129 ◽

2004 ◽

Vol 107 (5) ◽

pp. 505-511 ◽

Cited By ~ 8

Author(s):

Marcus FISCHER ◽

Wolfgang LIEB ◽

Daniel MAROLD ◽

Matthias BERTHOLD ◽

Andrea BAESSLER ◽

...

Keyword(s):

Risk Factors ◽

Myocardial Infarction ◽

Cardiovascular Risk ◽

Left Ventricular Function ◽

Cardiovascular Risk Factors ◽

Ventricular Function ◽

Systolic Function ◽

Receptor Gene ◽

Left Ventricular ◽

Deletion Polymorphism

The BK (bradykinin) B2 receptor is the major cellular mediator of the effects of BK. A 9 bp deletion in the promoter of the receptor gene represents an allelic variant that is associated with enhanced mRNA expression levels. We tested whether this polymorphism is associated with the prevalence of MI (myocardial infarction) or with echocardiographically determined left ventricular function in post-MI patients. Patients with documented MI (n=484), matched controls and controls without evidence of coronary heart disease (n=1363) constituted cases and controls. MI patients and controls were carefully matched for age, gender and cardiovascular risk factors. Genotype distributions of the 9 bp insertion/deletion polymorphism were similar across the groups: −9/−9, −9/+9 and +9/+9 were 22.1, 49.5 and 28.5% in MI patients, and 23.0, 44.6 and 32.5% in matched control subjects respectively. The lack of association was also observed in selected subgroups, stratified by age, gender and cardiovascular risk factors. Furthermore, there was no relation between this polymorphism and left ventricular systolic function in post-MI patients. These findings indicate that the 9 bp insertion/deletion polymorphism of the BK B2 receptor gene is neither related to the prevalence of MI nor to left ventricular function after MI.

Download Full-text