scholarly journals Comments on the association between reduced arterial stiffness and preserved diastolic function of the left ventricle in middle-aged and elderly patients

2017 ◽  
Vol 20 (1) ◽  
pp. 202-202
Author(s):  
Saeid Safiri ◽  
Erfan Ayubi
2017 ◽  
Vol 19 (6) ◽  
pp. 620-626 ◽  
Author(s):  
Kyung-Taek Park ◽  
Hack-Lyoung Kim ◽  
Sohee Oh ◽  
Woo-Hyun Lim ◽  
Jae-Bin Seo ◽  
...  

2021 ◽  
pp. 118-123
Author(s):  
E. S. Fomina ◽  
V. S. Nikiforov

Introduction. Increased arterial stiffness is one of the key links in the formation of cardiovascular pathology in older age groups. At the same time, the effect of vascular stiffness on myocardial function in cardiac patients with frailty remains insufficiently studied.Aim of study. Тo analyze the data of arterial stiffness and diastolic function of left ventricle (LV) in patients older than 65 years with arterial hypertension and frailty.Materials and methods. The study included 90 outpatient and inpatient patients older than 65 years with the presence of arterial hypertension. All patients were divided into two groups: with the presence and absence of frailty. To identify frailty, we used the questionnaire “Age is not a hindrance”, a short battery of physical activity tests. Methods of volumetric sphygmometry, echocardiography, including tissue Doppler were used. The obtained data were analyzed using a package of statistical programs.Results. The results of a comparative simultaneous non-randomized descriptive study of two groups of patients are presented. The study found that the systolic function, diastolic dysfunction of the left ventricle by the type of slowing down of LV relaxation in both groups did not significantly differ in their indicators. In the group of patients with frailty, LV diastolic dysfunction was significantly more often detected by the type of pseudonormalization – with an increase in filling pressure. When analyzing data of arterial stiffness, differences were obtained in both groups in the left cardio-ankle vascular index (LCAVI), systolic blood pressure (LB SAD), pulse pressure (LB PD) in the left shoulder area, and the delta of average blood pressure in the left ankle area (LA% IDA), which were significantly higher in patients with frailty.Conclusion. In the group of patients with hypertension older than 65 years with frailty, a violation of the LV diastolic function by the  type of  pseudonormalization with an increase in  filling pressure prevails. An increase in  filling pressure in  the  group of patients older than 65 years with hypertension and the presence of frailty is associated with an increase in the complex of indicators characterizing arterial stiffness – the cardio-ankle vascular index, systolic blood pressure, pulse pressure in the left shoulder area, the delta of average blood pressure in the left ankle area.


Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Jan Stritzke ◽  
Marcello R Markus ◽  
Stefanie Duderstadt ◽  
Wolfgang Lieb ◽  
Andreas Luchner ◽  
...  

Smoking is an important cardiovascular risk factor and thereby strongly related to cerebral ischemia and myocardial infarction. Here we evaluated subclinical effects of smoking behaviors on arterial stiffness and left ventricular diastolic function in middle-aged individuals without known cardiovascular disease. Within a gender and age stratified random sample diastolic function was assessed by standardized echocardiography at baseline and again after ten years. Furthermore pulse wave analysis was performed at the follow-up investigation. Within a healthy subgroup aged 25 to 44 years at baseline (n=400) associations between smoking behaviors and LV diastolic function as well as arterial stiffness were assessed by comparison of non-smokers (nonS, consisted of never smokers and individuals who stopped active smoking at least 10 years before follow-up investigation), ex-smokers (exS, individuals who stopped smoking within 10 years of follow-up), and current smokers (curS). Adjusted mean values were calculated by linear regression models. As compared to non-smokers, current smokers as well as ex-smokers presented with worse diastolic function at follow-up. Specifically, they displayed lower e/a-ratios (curS 1.23 95%-CI [1.19, 1.28]; exS 1.23 [1.15, 1.32]) as compared to nonS (1.33 [1.29, 1.36], p-values 0.001 and 0.041, respectively). Additionally, declines of e/a-ratios associated with ageing by 10 years were also significantly different (curS −0.35 [−0.39, −0.31]; exS −0.39 [−0.46, −0.31]; vs. nonS −0.27 [−0.30, −0.24]; each p=0.006). Furthermore, curS presented with increased arterial stiffness as displayed by higher augmentation index (curS 20.1 [18.5, 21.6]; exS 16.7 [13.9, 19.6]; vs. nonS 16.7 [15.5, 17.9], p<0.001 and p=0.995) and shorter time to reflection (curS 141ms [139, 143]; exS 147ms [143, 151]; vs. nonS 145ms [143, 146], p=0.005 and p=0.265). In middle-aged healthy individuals smoking is strongly related to subclinical changes in arterial stiffness and diastolic function. But even after termination of active smoking these changes partly persist. Consequently, interventional programs addressing younger adults are essential to prevent premature cardiovascular ageing.


2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1424.3-1425
Author(s):  
I. Kirillova ◽  
D. Novikova ◽  
T. Popkova ◽  
Y. Gorbunova ◽  
E. Markelova ◽  
...  

Background:Objectives:to evaluate the effect of antirheumatic therapy according to the “treat to target” strategy on the course of chronic heart failure (CHF) in patients with early RA.Methods:The study included 22 patients CHF with valid diagnosis of RA (criteria ACR / EULAR, 2010), 17 (77%) of women, median (Me) age - 60 years, Me disease duration - 7 months; IgM seropositive for rheumatoid factor 10 (45%) and / or antibodies to the cyclic citrulline peptide 22 (100%), DAS28-5.6 [4,8;6,5]. CHF verified in accordance the recommendations for the diagnosis and treatment of CHF Society of Specialists in Heart Failure (2013). The concentration of NT-proBNP was determined by electrochemiluminescence. For all patients was started methotrexate (MT) therapy with a rapid increase in the dose to 30 mg per week subcutaneously. If the MT was not effective enough, after 3 months a biological Disease-Modifying Anti-Rheumatic Drug (bDMARDs) was added to the therapy, predominantly TNF-alpha inhibitors. After 18 months, 10 (45%) patients were in remission and low disease activity, 6 (60%) of patients underwent MT therapy in combination with bDMARDs.Results:In baseline CHF with preserved EF was revealed in 21 (95%) patients, in 1 patient - CHF with reduced EF. After 18 months there was a positive dynamics of improvement of clinical symptoms, echocardiographic indicators (decrease the size of the left atrium (LА) and the index of end-systolic volume of LА, IVRT, E’ LV), diastolic function of the left ventricle (LV). There was no decompensation of CHF. LV diastolic function normalized in 7 (32%) patients who reached the target level of blood pressure, remission (n = 5) and low (n = 2) disease activity, mainly in the treatment of MT and bDMARDs. In patients with RA and CHF, the level of NT-proBNP decreased from 192.2 [151.4; 266.4] to 114.0 [90.4; 163.4] pg / ml (p <0.001), normalized in 16 of 22 (73%) patients (p <0.001) with remission or low RA activity. In 5 (22%) patients, the clinical manifestations of CHF regressed, LV diastolic function and NT-proBNP level normalized.Conclusion:In patients with early RA and CHF anti-rheumatic therapy improves the clinical course of CHF. There were an improvement in the clinical course of CHF, diastolic function of the left ventricle and a decrease in NT-proBNP.Disclosure of Interests:None declared


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