E27 No effect of aortic stiffness on left ventricular patients with symptomatic coronary artery disease

Purpose Hypertension is an important cause of nonischemic heart failure. It is important to identify subclinical left ventricular dysfunction in patients with hypertension in an early stage to lower the risk of progression to more severe illness. The aim of our study was to assess the correlation between indices of left ventricular function and aortic stiffness in patients with hypertension. Methods Our study was a case control study of 42 hypertensive and 40 normotensive patients with nonsignificant coronary artery disease. All the patients underwent echocardiography and left ventricular ejection fraction, global longitudinal strain, post systolic index, pulsed Doppler early transmitral peak flow velocity, early diastolic mitral annular velocity (e′), and aortic elasticity measurements were calculated. Results The hypertensive patients were older (58.47 ± 9.57 vs. 52.94 ± 10.38 years, p = 0.018) and had a higher body mass index (30.09 ± 5.08 vs. 27.48 ± 4.17 kg/m2, p = 0.013) and E/e′ ratio (8.16 ± 1.81 vs. 6.56 ± 1.71, p < 0.001) and a lower e′ velocity (8.25 ± 2.28 vs. 9.52 ± 2.34 cm/s, p = 0.015) than normotensives. They also had a lower aortic distensibility ( p = 0.008) and a higher aortic stiffness index ( p = 0.039) compared with the normotensive group. The hypertensive patients did not show any association between aortic elasticity and stiffness with age or e′ velocity despite significant association in normotensives. Conclusion Hypertension is associated with a high prevalence of diastolic dysfunction, elevated left ventricular filling pressure, and increased arterial stiffness, all of which have significant association with adverse outcomes. The measurements found in the hypertensive patients compared with the normotensive group may be due to several age-independent mechanisms.

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Low Vitamin D and High Parathyroid Hormone Levels Are Associated with Left Ventricular Dysfunction but Not with Increased Aortic Stiffness in Patients Undergoing Cardiac Catheterization for Coronary Artery Disease.

Journal of Cardiac Failure ◽

10.1016/j.cardfail.2010.06.107 ◽

2010 ◽

Vol 16 (8) ◽

pp. S32

Author(s):

Hidekatsu Fukuta ◽

Nobuyuki Ohte ◽

Kazuaki Wakami ◽

Toshihiko Goto ◽

Seiji Mukai ◽

...

Keyword(s):

Coronary Artery Disease ◽

Vitamin D ◽

Parathyroid Hormone ◽

Coronary Artery ◽

Cardiac Catheterization ◽

Left Ventricular Dysfunction ◽

Aortic Stiffness ◽

Ventricular Dysfunction ◽

Left Ventricular ◽

Artery Disease

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Relationship Between Renal Function, Aortic Stiffness and Left Ventricular Function in Patients With Coronary Artery Disease

Circulation Journal ◽

10.1253/circj.cj-09-0185 ◽

2009 ◽

Vol 73 (9) ◽

pp. 1740-1745 ◽

Cited By ~ 7

Author(s):

Hidekatsu Fukuta ◽

Nobuyuki Ohte ◽

Seiji Mukai ◽

Kaoru Asada ◽

Kazuaki Wakami ◽

...

Keyword(s):

Coronary Artery Disease ◽

Renal Function ◽

Coronary Artery ◽

Left Ventricular Function ◽

Ventricular Function ◽

Aortic Stiffness ◽

Left Ventricular ◽

Artery Disease

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Impact of aortic stiffness on myocardial ischaemia in non-obstructive coronary artery disease

Open Heart ◽

10.1136/openhrt-2018-000981 ◽

2019 ◽

Vol 6 (1) ◽

pp. e000981 ◽

Cited By ~ 4

Author(s):

Mai Tone Lønnebakken ◽

Ingeborg Eskerud ◽

Terje Hjalmar Larsen ◽

Helga Bergljot Midtbø ◽

Marina Victorovna Kokorina ◽

...

Keyword(s):

Coronary Artery Disease ◽

Coronary Artery ◽

Myocardial Ischaemia ◽

Stable Angina ◽

Aortic Stiffness ◽

Obstructive Coronary Artery Disease ◽

Left Ventricular ◽

Applanation Tonometry ◽

Multivariable Logistic Regression Analysis ◽

Artery Disease

ObjectiveHigh aortic stiffness may reduce myocardial perfusion pressure and contribute to development of myocardial ischaemia. Whether high aortic stiffness is associated with myocardial ischaemia in patients with stable angina and non-obstructive coronary artery disease (CAD) is less explored.MethodsAortic stiffness was assessed as carotid-femoral pulse wave velocity (PWV) by applanation tonometry in 125 patients (62±8 years, 58% women) with stable angina and non-obstructive CAD participating in the Myocardial Ischemia in Non-obstructive CAD project. PWV in the highest tertile (>8.7 m/s) was taken as higher aortic stiffness. Stress-induced myocardial ischaemia was detected as delayed myocardial contrast replenishment during stress echocardiography, and the number of left ventricular (LV) segments with delayed contrast replenishment as the extent of ischaemia.ResultsPatients with higher aortic stiffness were older with higher LV mass index and lower prevalence of obesity (all p<0.05), while angina symptoms, sex, prevalence of hypertension, diabetes, smoking or LV ejection fraction did not differ between groups. Stress-induced myocardial ischaemia was more common (73% vs 42%, p=0.001) and the extent of ischaemia was larger (4±3 vs 2±3 LV segments, p=0.005) in patients with higher aortic stiffness. In multivariable logistic regression analysis, higher aortic stiffness was associated with stress-induced myocardial ischaemia independent of other known covariables (OR 4.74 (95% CI 1.51 to 14.93), p=0.008).ConclusionsIn patients with stable angina and non-obstructive CAD, higher aortic stiffness was associated with stress-induced myocardial ischaemia. Consequently, assessment of aortic stiffness may add to the diagnostic evaluation in patients with non-obstructive CAD.Trial registration numberNCT01853527.

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