Arterial stiffness in heart failure patients: dependance on diastolic dysfunction and plasma aldosterone levels

Giannattasio, Cristina; Achilli, Felice; Failla, Monica; Capra, Anna; Vincenzi, Antonella; Gentile, Gaetano; Corsi, Davide; Zazzeron, C.; Turolo, Lucia; Morganti, Alberto; Mancia, Giuseppe

doi:10.1016/j.ehjsup.2004.09.006

Cited by 11 publications

(8 citation statements)

References 27 publications

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“…It has been demonstrated in experimental animals that adventitial collagen is associated with arterial stiffening; a well-known undesirable structural change associated with ageing processes which can lead to systolic hypertension and cardiac failure (17). Previous studies have demonstrated that chronic and/or acute heart failure (AHF) states are frequently accompanied by an increase in large artery stiffness (18,19). On the other hand, IABP determines beneficial effects in the failing circulatory system by reducing systolic and increasing diastolic aortic blood pressure.…”

Section: Discussionmentioning

confidence: 99%

The Adventitia Layer Modulates the Arterial Wall Elastic Response to Intra‐Aortic Counterpulsation: In Vivo Studies

et al. 2013

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There is a relationship between the intra-aortic balloon pumping (IABP) benefits and the dynamic behavior of muscular arteries, which is associated with induced changes on the vessel walls through an endothelial-dependent mechanism. The arterial wall elastic behavior is influenced by adventitial function; however, no studies were performed in order to elucidate if this layer plays a role in the changes determined by IABP. Our aim was to quantify acute IABP effects on the mechanical properties of muscular arteries in induced acute heart failure (AHF), before and after adventitia removal. Pressure and diameter were recorded in the iliac arteries (IA) of sheep (n = 7), before and during 1:2 IABP: (i) in control state (CS) with intact IA, (ii) in CS after IA adventitia removal, and (iii) in de-adventitialized IA after AHF. Conduit function, compliance and arterial distensibility were calculated in each state. During CS, IABP resulted in intact IA dilatation and in an increase in conduit function, compliance and distensibility; adventitial removal determined an increase of arterial stiffness with respect to the CS, which decreased when IABP was used; the increase in arterial stiffness observed after adventitia removal was also detected in AHF state; IABP improves conduit function and arterial stiffness in de-adventitialized arteries, both before and during AHF. However, the improvement in these properties was lower than in intact arteries. Before and after AHF induction, the improvements of conduit function and arterial distensibility determined by IABP in intact IA were significantly reduced after adventitia removal. Adventitial layer integrity would be necessary to maximize IABP-related beneficial effects on arterial system properties.

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Section: Discussionmentioning

confidence: 99%

The Adventitia Layer Modulates the Arterial Wall Elastic Response to Intra‐Aortic Counterpulsation: In Vivo Studies

et al. 2013

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“…Concerning hypertensives with normal LV mass, the presence of the latter geometric pattern has been associated with increased rate of adverse cardiovascular events compared to normal LV geometry, and this fact could explain the importance of the aforementioned association between c-f PWV and increased RWT in our cohort. Furthermore, in a rather analogous state of heart failure, the arterial stiffening seems to increase in parallel with the progression of the disease, and is correlated with the reduced ability of the heart to relax, independently from the presence of LV hypertrophy [14].…”

Section: Discussionmentioning

confidence: 99%

“…Even if the recent guidelines of the European Society of Hypertension (ESH) [12] and the Joint National Committee (JNC) VII [13] do not recommend the routine measurement of this parameter in hypertensive patients, increased PWV is an independent predictor of adverse cardiovascular events in various clinical settings [14,15]. Arterial stiffening leads to increased pulse pressure and to LV hypertrophy [16], which is the most common causative factor for LV diastolic dysfunction.…”

Section: Introductionmentioning

confidence: 99%

Left ventricular diastolic dysfunction is accompanied by increased aortic stiffness in the early stages of essential hypertension: a TDI approach

Tsioufis

Chatzis

Dimitriadis

et al. 2005

Journal of Hypertension

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“…Consequently, as a quality control for the logistic regression models, we used the drop-one-out method, removing one of the covariates from the 5-covariate model, as well as determining areas under the curve (AUCs), the Akaike Information Criterion (AIC), and residual deviance. 22 In this way, we investigated whether a simpler model would be more appropriate for the data.…”

Section: Patientsmentioning

confidence: 99%

Association between high arterial stiffness and left ventricular filling pressures in patients with acute myocardial infarction

Milewska¹,

Krauze²,

Piskorski³

et al. 2015

Polish Archives of Internal Medicine

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814velocity (e') is the most accurate noninvasive approximation of instantaneous LV filling pressures. 6 An E/e' ratio exceeding 15 (E/e' >15) is considered to indicate abnormally elevated LV filling pressures 7 in various conditions, including acute myocardial infarction (MI). 8Although abnormal myocardial contraction is typical for acute MI, LV diastolic dysfunction also worsens at this time.9 A series of hemodynamic derangements caused by acute MI affects the mechanical and functional properties of arterial walls, including stiffness.10-12 A decrease in LV stroke volume leads to a reflex increase in vascular resistance and cardiac afterload, which may cause higher systolic and diastolic pressure within the left ventricle. 12IntroductIon Various risk factors or cardiovascular diseases (eg, hypertension, diabetes, aging, or ischemic heart disease) predispose towards the development of left ventricular (LV) diastolic dysfunction.1,2 A community-based study that included apparently healthy individuals reported that approximately 20% of the general population had LV diastolic dysfunction (usually asymptomatic).3 Arterial stiffness contributes significantly to the development of LV diastolic dysfunction, and both pathologies share similar risk factors. 4 Increased arterial stiffness worsens prognosis in hypertensive patients with high or very high cardiovascular risk. 5There are several indices of LV diastolic dysfunction, but the ratio of early transmitral flow velocity (E) to early diastolic septal mitral annulus ABstrActIntroductIon High arterial stiffness increases the left ventricular (LV) filling pressures in different cardiac disorders. The association between arterial stiffness and LV filling pressures has not been studied so far in patients with acute myocardial infarction (MI).oBjectIves The aim of the study was to assess the association between arterial stiffness and LV filling pressures in patients with acute MI.PAtIents And methods Arterial stiffness, measured using the digital volume pulse stiffness index (SI DVP ), and LV filling pressures, quantified as the ratio of early transmitral flow velocity to early diastolic septal mitral annulus velocity (E/e'), were evaluated in 263 patients with acute MI (mean age, 63.8 ±11 years; 69 women). The association between high E/e' (>15) and very stiff arteries (SI DVP >18 m/s) was analyzed by logistic regression, with data presented as odds ratios (ORs) and 95% confidence intervals (CIs).results A multivariate logistic regression analysis revealed an association between E/e' >15 and SI DVP >18 m/s (OR, 4.7; 95% CI, 1.8-12.3), independently of female sex (OR, 4.3; 95% CI, 1.4-10.2), LV ejection fraction <35% (OR, 3.1; 95% CI, 1.2-8.2), left atrial volume >34 ml/m 2 (OR, 17.4; 95% CI, 5.8-52.0). There was no significant association between E/e' >15 and previous MI (OR, 2.2; 95% CI, 0.9-5.7).conclusIons High arterial stiffness is an independent risk factor for LV diastolic dysfunction in patients with acute MI. A reduction in arterial stiffness may improve LV ...

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Arterial stiffness in heart failure patients: dependance on diastolic dysfunction and plasma aldosterone levels

Cited by 11 publications

References 27 publications

The Adventitia Layer Modulates the Arterial Wall Elastic Response to Intra‐Aortic Counterpulsation: In Vivo Studies

The Adventitia Layer Modulates the Arterial Wall Elastic Response to Intra‐Aortic Counterpulsation: In Vivo Studies

Left ventricular diastolic dysfunction is accompanied by increased aortic stiffness in the early stages of essential hypertension: a TDI approach

Association between high arterial stiffness and left ventricular filling pressures in patients with acute myocardial infarction

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