Impaired Left Ventricular Relaxation and Arterial Stiffness in Patients with Essential Hypertension

Chang, Kai-Shiun; Tseng, Yung‐Zu; Kuo, Te Son; Chen, H. I.

doi:10.1042/cs0870641

Cited by 30 publications

(24 citation statements)

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“…Forced inspiration against increased airway resistance during wakefulness (Mueller manoeuvre) raises aortic transmural pressure, thereby increasing aortic stiffness and left ventricular systolic load [39]. Isovolumic relaxation time of the left ventricle has also been shown to increase in the presence of either hypertension-related or age-dependent increase in aortic stiffness [40].…”

Section: Discussionmentioning

confidence: 99%

Impact of obstructive sleep apnoea on left ventricular mass and global function

Dursunoğlu¹

2005

Eur Respir J

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Obstructive sleep apnoea syndrome (OSAS) might be a cause of heart failure. The present study aimed to assess left ventricular mass and myocardial performance index (MPI) in OSAS patients.A total of 67 subjects without any cardiac or pulmonary disease, referred for evaluation of OSAS, had overnight polysomnography and echocardiography. According to apnoea-hypopnoea index (AHI), subjects were classified into three groups: mild OSAS (AHI: 5-14; n516), moderate OSAS (AHI: 15-29; n518), and severe OSAS (AHI: o30; n533). Thickness of interventricular septum (IVS) and posterior wall (LVPW) were measured by M-mode, along with left ventricular mass (LVM) and LVM index (LVMI). Left ventricular MPI was calculated as (isovolumic contraction time+isovolumic relaxation time)/aortic ejection time by Döppler echocardiography.There were no differences in age or body mass index among the groups, but blood pressures were higher in severe OSAS compared with moderate and mild OSAS. In severe OSAS, thickness of IVS (11.2¡1.1 mm), LVPW (11.4¡0.9 mm), LVM (298.8¡83.1 g) and LVMI (144.7¡39.8 g?m , respectively). In severe OSAS, MPI (0.64¡0.14) was significantly higher than in mild OSAS (0.50¡0.09), but not significantly higher than moderate OSAS (0.60¡0.10).In conclusion, severe and moderate obstructive sleep apnoea syndrome patients had higher left ventricular mass and left ventricular mass index, and also left ventricular global dysfunction.

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Section: Discussionmentioning

confidence: 99%

Impact of obstructive sleep apnoea on left ventricular mass and global function

Dursunoğlu¹

2005

Eur Respir J

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“…137 Several observations in different populations reported the dependence of ventricular diastolic function on timing and amplitude of reflected pressure waves. 137,138 Therefore, the reduction of E-wave amplitude and the inversion of E/ A ratio, commonly observed at transmitral Doppler examination in hypertensive patients, may be an expression of the physiological response of myocardial fibres to an abrupt overload generated by the early return of reflected pressure waves (load dependence of myocardial relaxation). 139 When diastolic function is assessed by tissue Doppler, E 0 also results inversely associated with vascular load, and this association is most pronounced for late systolic load, which is mediated predominantly by systolic wave reflections.…”

Section: Diastolic Functionmentioning

confidence: 99%

Ventricular–vascular coupling in hypertension

Saba

Cameli

Casalnuovo

et al. 2014

Journal of Cardiovascular Medicine

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The present review is addressed to analyse the complex interplay between left ventricle and arterial tree in hypertension. The different methodological approaches to the analysis of ventricular-vascular coupling in the time and frequency domain are discussed. Moreover, the role of hypertension-related changes of arterial structure and function (stiffness and wave reflection) on arterial load and how ventricular-vascular coupling modulates the process of left ventricular adaptation to hypertension are analysed.The different interplay between vascular bed and left ventricle emerges as the pathophysiological basis for the development of the multiple patterns of ventricular structural adaptation in hypertension and provides a pathway for the interpretation of systolic and diastolic functional abnormalities observed in hypertensive patients. Targeting the therapeutic approach to improve ventricularvascular coupling may have relevant impact on reversing left ventricular hypertrophy and improving systolic and diastolic dysfunction. J Cardiovasc Med 2014, 15:773-787

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“…The reflection factor was calculated as the ratio between the amplitude of the backward to the amplitude of the forward wave in the time domain. 42 Calculations were performed with the use of custom written software, MATLAB for Windows version 5.2.1.1420 (The MathWorks, Inc), and Microsoft Excel 97.…”

Section: Aortic Impedancementioning

confidence: 99%

Muscular Strength Training Is Associated With Low Arterial Compliance and High Pulse Pressure

et al. 1999

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Abstract-Aerobic exercise training increases arterial compliance and reduces systolic blood pressure, but the effects of muscular strength training on arterial mechanical properties are unknown. We compared blood pressure, whole body arterial compliance, aortic impedance, aortic stiffness (measured by ␤-index and carotid pulse pressure divided by normalized systolic expansion Femoral-dorsalis pedis pulse wave velocity was also higher in the athletes, but carotid-femoral pulse wave velocity was not different. Furthermore, both carotid (56Ϯ3 versus 44Ϯ2 mm Hg; PϽ0.001) and brachial (60Ϯ3 versus 50Ϯ2 mm Hg; PϽ0.01) pulse pressures were higher in the athletes, but mean arterial pressure and resting heart rate did not differ between groups. These data indicate that both the proximal aorta and the leg arteries are stiffer in strength-trained individuals and contribute to a higher cardiac afterload. (Hypertension. 1999;33:1385-1391.) Key Words: mechanical properties, arterial Ⅲ stiffness Ⅲ compliance Ⅲ exercise A rterial compliance plays a role in determining both arterial systolic and diastolic pressure and therefore, in a clinical context, influences left ventricular size and function, coronary blood flow, and the risk of cerebrovascular accidents. [1][2][3] In the past, measures of arterial compliance in humans have been invasive, and therefore surrogate measures such as peripheral pulse pressure have been applied to investigate potential relationships with clinical outcomes. Pulse pressure correlates closely with serious cardiovascular outcomes such as myocardial infarction, 4 thus highlighting arterial compliance as a potential target for risk reduction therapy.Arterial compliance decreases with increasing age, 5-8 in atherosclerosis and coronary artery disease, 5,9 -12 and in hypertensive individuals. [13][14][15] Aerobic exercise has welldocumented efficacy for cardiovascular risk reduction, and it appears that at least part of its benefit derives from modification of arterial properties. In cross-sectional studies, aerobically trained athletes have a higher arterial compliance than sedentary individuals. 6,16,17 Furthermore, arterial compliance is elevated independently of blood pressure reduction in previously sedentary males after a 4-week program of moderate-intensity aerobic exercise training. 18 These data suggest that aerobic exercise structurally modifies the large arteries, a postulate supported by studies of ex vivo aortic properties in rats, after 16 weeks of spontaneous running. 19,20 While aerobic exercise is widely recommended as a preventative and therapeutic strategy, resistance-style training is becoming more popular, although it is less well studied with respect to its effects on blood pressure, and no previous study has examined arterial mechanical properties in this context. High-level resistance training is associated with abrupt and large pressor responses 21 and in the long term leads to a concentric ventricular hypertrophy. [22][23][24][25] We hypothesize that arterial mechanical modifica...

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Impaired Left Ventricular Relaxation and Arterial Stiffness in Patients with Essential Hypertension

Cited by 30 publications

References 0 publications

Impact of obstructive sleep apnoea on left ventricular mass and global function

Impact of obstructive sleep apnoea on left ventricular mass and global function

Ventricular–vascular coupling in hypertension

Muscular Strength Training Is Associated With Low Arterial Compliance and High Pulse Pressure

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