Change in Aortic End-Systolic Pressure by Alterations in Loading Sequence and Its Relation to Left Ventricular Isovolumic Relaxation

Kohno, Fujimasa; Kumada, Toshiaki; Kambayashi, Masashi; Hayashida, Wataru; Ishikawa, Noboru; Sasayama, Shígetake

doi:10.1161/01.cir.93.11.2080

Cited by 49 publications

(39 citation statements)

References 29 publications

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“…During early ejection, active development of fiber crossbridges occurs in the myocardium, whereas a transition from contraction to relaxation occurs in mid-to-late systole, during which increases in load may be particularly deleterious, leading to more hypertrophy and abnormal diastolic relaxation. 2,33 The differential effect of time-varying myocardial afterload on cellular processes taking place in early and late ejection is, therefore, an important area for future research.…”

Section: Discussionmentioning

confidence: 99%

Early and Late Systolic Wall Stress Differentially Relate to Myocardial Contraction and Relaxation in Middle-Aged Adults

et al. 2013

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A fterload is recognized as an important determinant of myocardial function. Experimental animal studies demonstrate that increased afterload impacts diastolic relaxation. [1][2][3][4][5] Furthermore, studies in healthy instrumented dogs showed that, within physiological ranges, increased afterload results in differential responses in relaxation depending on its timing. In anesthetized open-chest dogs, mild-to-moderate increases in early systolic load resulted in unchanged or slightly enhanced relaxation, whereas increases in late systolic load resulted in a slow rate of diastolic ventricular pressure fall. 2,6 This, however, was not observed in conscious dogs subjected to a similar protocol.7 More recently, greater late systolic pressure assessed from a carotid pressure waveform 8 or an invasively measured aortic pressure waveform 9 has been shown to be associated with impaired early diastolic relaxation in humans. These studies implicate the loading sequence as a potential mechanistic determinant of diastolic relaxation.Whereas analyses of central arterial pressure and pressureflow relations are highly informative regarding arterial properties and ventricular-arterial interactions, they do not describe the time-varying mechanical load (stress) on the myocardium, which is determined by complex interactions between myocardial contractile elements, instantaneous leftventricular (LV) geometry and the time-varying hydraulic Abstract-Experimental studies implicate late systolic load as a determinant of impaired left-ventricular relaxation. We aimed to assess the relationship between the myocardial loading sequence and left-ventricular contraction and relaxation.

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Section: Discussionmentioning

confidence: 99%

Early and Late Systolic Wall Stress Differentially Relate to Myocardial Contraction and Relaxation in Middle-Aged Adults

et al. 2013

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“…16 Excessive pressure pulsatility and premature wave reflection have a deleterious effect on left ventricular systolic and diastolic function, leading to atrial and ventricular remodeling and hypertrophy. 17,18 Natriuretic peptide and adrenomedullin levels have important and complex associations with measures of arterial stiffness. Atrial natriuretic peptide (ANP) and B-type natriuretic peptide (BNP) are released by the heart in response to atrial and ventricular loading conditions, respectively, 19 and act to reduce overload by virtue of their natriuretic properties.…”

Section: Clinical Perspective P 3085mentioning

confidence: 99%

Associations of Plasma Natriuretic Peptide, Adrenomedullin, and Homocysteine Levels With Alterations in Arterial Stiffness

et al. 2007

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“…Although animal and small human studies have shown that an acute increase in LV afterload, particularly in late-systolic load, adversely impacts on LV early diastolic relaxation, [8][9][10][11][12] little is known about its chronic effect on LV diastolic function. We hypothesized that enhanced late-systolic load may be associated with altered LV diastolic function at steady state.…”

mentioning

confidence: 99%

Impact of Arterial Load on Left Ventricular Diastolic Function in Patients Undergoing Cardiac Catheterization for Coronary Artery Disease

Fukuta

Ohte

Wakami

et al. 2010

Circ J

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Background:Although left ventricular (LV) diastolic dysfunction is associated with increased risk for incident heart failure in patients with coronary artery disease (CAD), no specific treatment for diastolic abnormalities has been established. Animal and small human studies have shown that an acute increase in LV afterload adversely impacts on LV early diastolic relaxation, but little is known about its chronic effect on diastolic function. Methods and Results:The relationships of various components of arterial load (arterial compliance, total vascular resistance index, and augmentation index [AI] in the ascending aorta) with LV diastolic function indices determined on cardiac catheterization (relaxation time constant [Tau] and end-diastolic pressure [EDP]) and those on tissue Doppler echocardiography (early diastolic mitral annular velocity [E'] and the ratio of early diastolic mitral inflow to annular velocities [E/E']) were investigated in 303 consecutive patients undergoing cardiac catheterization for CAD. All components of arterial load correlated with diastolic function indices, with AI, an index reflecting late-systolic load, having the strongest correlations with diastolic function indices. After adjustment for potential confounders, AI correlated with Tau (standardized β=0.25, P<0.001), EDP (β=0.25, P<0.001), E' (β= -0.21, P<0.001), and E/E' (β=0.23, P<0.001). Conclusions:Increased AI is independently associated with LV diastolic function in patients with known or suspected CAD. Late-systolic load may be a therapeutic target to improve LV diastolic abnormalities in this population. (Circ J 2010; 74: 1900 - 1905

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Change in Aortic End-Systolic Pressure by Alterations in Loading Sequence and Its Relation to Left Ventricular Isovolumic Relaxation

Cited by 49 publications

References 29 publications

Early and Late Systolic Wall Stress Differentially Relate to Myocardial Contraction and Relaxation in Middle-Aged Adults

Early and Late Systolic Wall Stress Differentially Relate to Myocardial Contraction and Relaxation in Middle-Aged Adults

Associations of Plasma Natriuretic Peptide, Adrenomedullin, and Homocysteine Levels With Alterations in Arterial Stiffness

Impact of Arterial Load on Left Ventricular Diastolic Function in Patients Undergoing Cardiac Catheterization for Coronary Artery Disease

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