Age-Related Changes in Left Ventricular/Arterial Coupling

Nichols, Wilmer W.; O’Rourke, Michael; Avolio, Alberto; Yaginuma, Toshio; Murgo, Joseph P.; Pepine, Carl J.; Conti, C. Richard

doi:10.1007/978-1-4613-8634-6_4

Cited by 23 publications

(26 citation statements)

References 102 publications

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“…Characteristic impedance represents stiffness of the proximal arterial bed, whereas arterial compliance represents stiffness of more distal parts of the arterial system. 28 Thus, the changes in these variables in the present study indicate that both proximal and peripheral arterial stiffness are increased in KD patients late after resolution of acute inflammation.…”

Section: Arterial Stiffening After Kdsupporting

confidence: 53%

“…These changes in KD patients were concurrent with increased wave reflection, which can adversely affect ventricular-vascular interaction. 28 Notably, these changes in arterial wall stiffness and wave reflection were observed even in patients whose CALs had morphologically (angiographically) regressed. Also, levels of circulating markers of endothelial dysfunction were associated with increased vascular stiffening after KD.…”

Section: Discussionmentioning

confidence: 93%

“…Arterial stiffness directly influences left ventricular afterload and coronary perfusion, 12,27,28 and it also appears to approximately parallel the extent of atherosclerosis. 45 Arterial stiffening may be sufficient on its own to cause endothelial dysfunction.…”

Section: Discussionmentioning

confidence: 99%

“…26,28 In systems without impedance mismatch, input impedance is equal to characteristic impedance. 28 Therefore, an increase in deviation of impedance spectra from characteristic impedance in KD patients (as indicated by increased reflection index) indicates an increase in impedance mismatch and thus increased variation in regional vascular properties or loss of homogeneity of the arterial bed, which results in increased wave reflection.…”

Section: Increased Wave Reflection After Kdmentioning

confidence: 99%

“…28 Histopathologic studies have demonstrated destruction of the coronary arterial wall during the acute phase of KD. 6,7,33 Infiltration by inflammatory cells begins in the intima with degradation of endothelial cells and disruption of the elastic lamina.…”

Section: Implications Of Changes In Arterial Hemodynamics After Kdmentioning

confidence: 99%

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Arterial Hemodynamics in Patients After Kawasaki Disease

et al. 2005

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Background-Histopathological findings in the acute stage of Kawasaki disease (KD) indicate widespread vascular inflammation that involves not only coronary arteries but also systemic arteries. This may cause changes in systemic arterial wall properties after KD, which could have adverse effects on arterial hemodynamics (an important predictor of cardiovascular morbidity and mortality). Methods and Results-Systemic arterial hemodynamics were investigated by measuring aortic input impedance during cardiac catheterization in 42 KD patients who had developed coronary artery lesions (CALs) in the acute stage of KD. The KD patients were subdivided into 2 groups according to the angiographic findings (group 1A, 26 patients with persistent CALs; group 1B, 16 patients with regressed CALs), and results were compared with those of 36 referents (group 2). Compared with referents, characteristic impedance was significantly higher for KD patients (137.0Ϯ5.1, 125.7Ϯ8.2, and 97.9Ϯ4.1 dyne · s · cm Ϫ5 · m 2 for group 1A, group 1B, and group 2, respectively), and total peripheral arterial compliance indexed to age-specific values was significantly lower for KD patients (group 1A 72.9Ϯ4.2% of normal; group 1B 70.6Ϯ5.9% of normal; group 2 97.7Ϯ4.0% of normal; for both variables, PϽ0.05 for each KD group versus group 2; PϭNS between KD groups), which suggests that both central and peripheral arterial wall stiffness increase after KD regardless of persistence of CALs. Also, indices of arterial wave reflection (reflection coefficient, reflection factor, and augmentation index) were all significantly higher in KD patients than in referents (PϽ0.05), with the result that the aortic pressure waveforms of the present KD patients resembled those generally observed in the elderly. In addition, levels of circulating markers of endothelial dysfunction (ACE and von Willebrand factor) were associated with increased vascular stiffening in KD patients but not in referents. Conclusions-These results indicating abnormal arterial hemodynamics after KD highlight the importance of regular monitoring of the systemic arterial bed and potentially relevant cardiovascular events in long-term follow-up of KD.

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Section: Arterial Stiffening After Kdsupporting

confidence: 53%

Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Section: Increased Wave Reflection After Kdmentioning

confidence: 99%

Section: Implications Of Changes In Arterial Hemodynamics After Kdmentioning

confidence: 99%

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Arterial Hemodynamics in Patients After Kawasaki Disease

et al. 2005

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Cardiovascular Physiology

Muir

2015

Veterinary Anesthesia and Analgesia

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Neural Control of Vascular Function in Skeletal Muscle

Shoemaker

Badrov

Al‐Khazraji

et al. 2015

Comprehensive Physiology

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The sympathetic nervous system represents a fundamental homeostatic system that exerts considerable control over blood pressure and the distribution of blood flow. This process has been referred to as neurovascular control. Overall, the concept of neurovascular control includes the following elements: efferent postganglionic sympathetic nerve activity, neurotransmitter release, and the end organ response. Each of these elements reflects multiple levels of control that, in turn, affect complex patterns of change in vascular contractile state. Primarily, this review discusses several of these control layers that combine to produce the integrative physiology of reflex vascular control observed in skeletal muscle. Beginning with three reflexes that provide somewhat dissimilar vascular patterns of response despite similar changes in efferent sympathetic nerve activity, namely, the baroreflex, chemoreflex, and muscle metaboreflex, the article discusses the anatomical and physiological bases of postganglionic sympathetic discharge patterns and recruitment, neurotransmitter release and management, and details of regional variations of receptor density and responses within the microvascular bed. Challenges are addressed regarding the fundamentals of measurement and how conclusions from one response or vascular segment should not be used as an indication of neurovascular control as a generalized physiological dogma. Whereas the bulk of the article focuses on the vasoconstrictor function of sympathetic neurovascular integration, attention is also given to the issues of sympathetic vasodilation as well as the impact of chronic changes in sympathetic activation and innervation on vascular health. © 2016 American Physiological Society.

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Age-Related Changes in Left Ventricular/Arterial Coupling

Cited by 23 publications

References 102 publications

Arterial Hemodynamics in Patients After Kawasaki Disease

Arterial Hemodynamics in Patients After Kawasaki Disease

Cardiovascular Physiology

Neural Control of Vascular Function in Skeletal Muscle

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