Impact of aortic root size on left ventricular afterload and stroke volume

Sahlén, Anders; Hamid, Nadira; Amanullah, Mohammed; Fam, Jiang Ming; Yeo, Khung Keong; Lau, Yee How; Lam, Carolyn S.P.; Ding, Zee Pin

doi:10.1007/s00421-016-3392-0

Cited by 13 publications

(10 citation statements)

References 63 publications

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“…However, a fully personalized model would not be possible, since this would require us to obtain numerous noninvasive and invasive measurements for every individual. Since CO is known to be particularly dependent on arterial geometry measurements [73], individualized CO prediction still remains a challenge.…”

Section: A Limitationsmentioning

confidence: 99%

Noninvasive Cardiac Output and Central Systolic Pressure From Cuff-Pressure and Pulse Wave Velocity

Bikia

Pagoulatou

Trachet

et al. 2020

IEEE J. Biomed. Health Inform.

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Goal: We introduce a novel approach to estimate cardiac output (CO) and central systolic blood pressure (cSBP) from noninvasive measurements of peripheral cuff-pressure and carotid-to-femoral pulse wave velocity (cf-PWV). Methods: The adjustment of a previously validated one-dimensional arterial tree model is achieved via an optimization process. In the optimization loop, compliance and resistance of the generic arterial tree model as well as aortic flow are adjusted so that simulated brachial systolic and diastolic pressures and cf-PWV converge towards the measured brachial systolic and diastolic pressures and cf-PWV. The process is repeated until full convergence in terms of both brachial pressures and cf-PWV is reached. To assess the accuracy of the proposed framework, we implemented the algorithm on in vivo anonymized data from 20 subjects and compared the methodderived estimates of CO and cSBP to patient-specific measurements obtained with Mobil-O-Graph apparatus (central pressure) and two-dimensional transthoracic echocardiography (aortic blood flow). Results: Both CO and cSBP estimates were found to be in good agreement with the reference values achieving an RMSE of 0.36 L/min and 2.46 mmHg, respectively. Low biases were reported, namely-0.04±0.36 L/min for CO predictions and-0.27±2.51 mmHg for cSBP predictions. Significance: Our onedimensional model can be successfully "tuned" to partially patient-specific standards by using noninvasive, easily obtained peripheral measurement data. The in vivo evaluation demonstrated that this method can potentially be used to obtain central aortic hemodynamic parameters in a noninvasive and accurate way.

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Section: A Limitationsmentioning

confidence: 99%

Noninvasive Cardiac Output and Central Systolic Pressure From Cuff-Pressure and Pulse Wave Velocity

Bikia

Pagoulatou

Trachet

et al. 2020

IEEE J. Biomed. Health Inform.

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“…Aortic root aneurysm is characterized by slower blood flow and endothelial dysfunction, which cause thrombi to form easily, and aortic root size is an independent determinant of larger stroke volume. 7 Therefore, we speculate that the emboli of the basilar artery might originate from aortic root aneurysm.…”

Section: Discussionmentioning

confidence: 90%

A Rare Case Report of Endovascular Therapy for Basilar Artery Occlusion in a Young Adult with Marfan Syndrome

Zhu

Zhang

et al. 2022

Vasc Endovascular Surg

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Basilar artery occlusion (BAO) is one of the most devastating types of ischaemic stroke and is identified by using computed tomography (CT) angiography. Marfan syndrome is an autosomal dominant disorder involving multisystem connective tissue, and the neurological complications are relatively rare. In this article, we report a case of a young Marfan syndrome patient complicated with BAO ischaemic stroke. The patient was an 18-year-old man with right hemiparesis, aphasia and impaired consciousness. CT angiography of the brain showed an occlusion distal to the basilar artery. Endovascular therapy including intravenous thrombolysis and mechanical thrombectomy (MT) was administered to this patient inside the therapeutic window. The patient had a favourable clinical outcome after endovascular therapy. Marfan syndrome may be a rare cause of ischaemic stroke with BAO. In addition, our report provides some evidence that can be used as a reference when planning therapeutic strategies for BAO patients with Marfan syndrome.

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“…4 The authors suggested that dilation of the AoR in elderly and hypertensive patients may be favorable, possibly by mitigating the adverse impact of concomitant aortic wall stiffening. 29 Thus, simultaneous studies of AoR dilation and arterial stiffness in transplant patients are justified.…”

Section: Discussionmentioning

confidence: 99%

Dilatation of aortic root in patients after kidney transplantation

Obremska¹,

Boratyńska²,

Szymczak³

et al. 2018

Polish Archives of Internal Medicine

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INTRODUCTION Aortic root (AoR) dilation is associated with cardiac damage and higher cardiovascular risk. Cardiovascular disease is the most common cause of death in patients after kidney transplantation (KTx ). OBJECTIVES The aim of this study was to assess the prevalence of enlarged AoR diameter in KTx recipients. Patients with bicuspid aortic valve, significant valvular disease, or evidence of connective tissue disorder were excluded. PATIENTS AND METHODS A total of 87 KTx recipients were divided into 2 groups depending on immunosuppressive regimen: 41 patients receiving mammalian target of rapamycin inhibitors (mTORi) and 46 patients treated with calcineurin inhibitors (CNIs). In all patients, echocardiography was performed, laboratory and clinical markers of cardiovascular risk were assessed, and the AoR diameter was calculated. RESULTS There were no differences between groups in age, sex, body surface area, body mass index, frequency of diabetes, hypertension, dyslipidemia, time after replacement therapy, creatinine levels, and estimated glomerular filtration rate. In the CNI group, the observed and calculated AoR diameters were similar (P = 0.8). In the mTORi group, the observed AoR diameter was higher than the calculated one (P = 0.002). The concentric and eccentric left ventricular hypertrophy was similar in both groups (P = 0.12 and P = 0.69, respectively). In the stepwise regression analysis, the AoR diameter was associated with body surface area and mTORi treatment. CONCLUSIONS KTx recipients have a high prevalence of AoR dilation. Immunosuppressive regimen based on mTORi increases the incidence of AoR enlargement.

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Impact of aortic root size on left ventricular afterload and stroke volume

Abstract: Larger aortic root size is an independent determinant of EA and SV. This association was heterogeneous and stronger in patients on CCB therapy.

Cited by 13 publications

References 63 publications

Noninvasive Cardiac Output and Central Systolic Pressure From Cuff-Pressure and Pulse Wave Velocity

Noninvasive Cardiac Output and Central Systolic Pressure From Cuff-Pressure and Pulse Wave Velocity

A Rare Case Report of Endovascular Therapy for Basilar Artery Occlusion in a Young Adult with Marfan Syndrome

Dilatation of aortic root in patients after kidney transplantation

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