Males with abdominal aortic aneurysm have reduced left ventricular systolic and diastolic function

Malm, Ida Åström; Basso, Rachel De; Engvall, Jan; Blomstrand, Peter

doi:10.1111/cpf.12728

Cited by 6 publications

(5 citation statements)

References 25 publications

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“…Increased afterload of the heart has negative consequences on the systolic function. This is confirmed by the observation of Malm et al, that patients with AAA have significantly decreased systolic function assessed by global longitudinal strain and ejection fraction [48]. The time from the beginning of the pressure wave to the first systolic peak (CT1) defines the first phase of the systole, in which ventricles start to contract.…”

Section: Discussionsupporting

confidence: 54%

“…The CT1 is dependent on the contractility of the left ventricle and the afterload. As has been shown by Malm et al global longitudinal strain (GLS), which is a surrogate marker of systolic function of the left ventricle is slightly decreased in patients with AAA when compared to a control group [48]. Thus, the shortening of the CT1 cannot be affected by the increased contractility of the left ventricle but is a result of changes in the afterload.…”

Section: Discussionmentioning

confidence: 87%

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Abdominal aortic aneurysm influences the indices of arterial stiffness recorded by pulse wave analysis

Nawrocka,

Krzykwa,

Artyszuk

et al. 2023

Arterial Hypertension

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Background: Abdominal aortic aneurysm (AAA), forming a blood reservoir alters the geometry of the aorta, which along with increased stiffness of the aortic wall modifies central blood pressure wave, especially the reflected wave. The aim of the study was to compare indices of arterial stiffness recorded by pulse wave analysis (PWA) between patients with AAA and controls. Material and methods: Sixty-nine patients (from 75 originally included) with asymptomatic AAA and 69 (from 74) age-, sex-and body mass index (BMI)-matching patients as a control group were analysed. The following variables of PWA recorded by applanation tonometry were evaluated: central pulse pressure (CPP), central systolic (CSBP) and diastolic (CDBP) blood pressure, central augmentation index (CAIx), the time from the beginning of a pulse wave to: the first systolic peak (CT1), to the beginning of the reflected wave (CT1R) and to the second systolic peak pressure (CT2). Results: Patients with AAA had higher CAIx [33% (12) vs. 28% (20); p < 0.001] than in the control group, lower CPP [36 mm Hg (10) vs. 45 mm Hg (24); p < 0.001), higher CDBP [79 mm Hg ( 14) vs. 73 mm Hg (13); p = 0.017) and no significant difference in CSBP [115 mm Hg (15) vs. 119 mm Hg (23); NS). Shorter CT1 [102 ms (9) vs. 106 ms (12); p = 0.004) and CT1R [133 ms (11) vs. 138 ms (13.5); p = 0.04) and longer CT2 (232 ms (36) vs. 217 ms (35); p = 0.007) were observed in patients with AAA. Data are presented as median with interquartile range. Conclusion: Differences of central blood pressure variables suggest increased arterial stiffness in patients with AAA. Despite lower values of pulse pressure, overall pressure load of the returning wave is higher, which affect the afterload of the heart.

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Section: Discussionsupporting

confidence: 54%

Section: Discussionmentioning

confidence: 87%

Abdominal aortic aneurysm influences the indices of arterial stiffness recorded by pulse wave analysis

Nawrocka,

Krzykwa,

Artyszuk

et al. 2023

Arterial Hypertension

View full text Add to dashboard Cite

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“…For example, the co-prevalence of AAA and thoracic aortic aneurysm is 10–30% [ 7 – 9 ]. Further, recent studies associated AAA with increased left-ventricular workload and faster ageing of the central arteries [ 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

Wall shear stress and relative residence time as potential risk factors for abdominal aortic aneurysms in males: a 4D flow cardiovascular magnetic resonance caseâ€“control study

Trenti

Ziegler

Bjarnegård

et al. 2022

Journal of Cardiovascular Magnetic Resonance

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Background Abdominal aortic aneurysms (AAA) can lead to catastrophic events such as dissection or rupture, and are an expression of general aortic disease. Low wall shear stress (WSS), high oscillatory shear index (OSI), and high relative residence time (RRT) have been correlated against increased uptake of inflammatory markers in the vessel wall and may improve risk stratification of AAA. We sought to obtain a comprehensive view of WSS, OSI, and RRT in the whole aorta for patients with AAA and age-matched elderly controls and young normal controls. Methods 4D Flow cardiovascular magnetic resonance images of the whole aorta were acquired in 18 AAA patients (70.8 ± 3.4 years), 22 age-matched controls (71.4 ± 3.4 years), and 23 young subjects (23.3 ± 3.1 years), all males. Three-dimensional segmentations of the whole aorta were created for all timeframes using a semi-automatic approach. The aorta was divided into five segments: ascending aorta, arch, descending aorta, suprarenal and infrarenal abdominal aorta. For each segment, average values of peak WSS, OSI, and RRT were computed. Student’s t-tests were used to compare values between the three cohorts (AAA patients vs elderly controls, and elderly controls vs young controls) where the data were normally distributed, and the non-parametric Wilcoxon rank sum tests were used otherwise. Results AAA patients had lower peak WSS in the descending aorta as well as in the abdominal aorta compared to elderly controls (p ≤ 0.001), similar OSI, but higher RRT in the descending and abdominal aorta (p ≤ 0.001). Elderly controls had lower peak WSS compared to young controls throughout the aorta (p < 0.001), higher OSI in all segments except for the infrarenal aorta (p < 0.001), and higher RRT throughout the aorta, except the infrarenal aorta (p < 0.001). Conclusions This study provides novel insights into WSS, OSI, and RRT in patients with AAA in relation to normal ageing, highlighting how AAA patients have markedly abnormal hemodynamic stresses not only in the infrarenal, but in the entire aorta. Moreover, we identified RRT as a marker for abnormal AAA hemodynamics. Further investigations are needed to explore if RRT or other measures of hemodynamics stresses best predict AAA growth and/or rupture.

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“…Quantitation calculation of BP for general aortic parts revealed that Emax was negatively associated with thrombus formation while E min was positively related. It has been reported that male AAA patients had reduced ventricular systolic and diastolic function ( Åström Malm et al, 2022 ). Our result indicated that for patients with CHD (both HFrEF and HFpEF) in clinical practice, we should pay more attention to their increased risk of thrombus formation after EVAR.…”

Section: Discussionmentioning

confidence: 99%

Effects of cardiac function alterations on the risk of postoperative thrombotic complications in patients receiving endovascular aortic repair

Sun

Li²,

He³

et al. 2023

Front. Physiol.

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Introduction: Chronic heart disease (CHD) is a common comorbidity of patients receiving endovascular aneurysm repair (EVAR) for abdominal aortic aneurysms (AAA). The explicit relationship between ventricular systolic function and EVAR complication of thrombotic events is unknown.Methods: In this study, we proposed a three-dimensional numerical model coupled with the lumped-elements heart model, which is capable of simulating thrombus formation in diverse systolic functions. The relation of cardiac functions and the predicted risk of thrombus formation in the aorta and/or endograft of 4 patients who underwent EVAR was investigated. Relative risks for thrombus formation were identified using machine-learning algorithms.Results: The computational results demonstrate that thrombus tended to form on the interior side of the aorta arch and iliac branches, and cardiac function can affect blood flow field and affect thrombus formation, which is consistent with the four patients' post-operative imaging follow-up. We also found that RRT, OSI, TAWSS in thrombosis area are lower than whole average. In addition, we found that the thrombus formation has negative correlations with the maximum ventricular contractile force (r = −.281 ± .101) and positive correlations with the minimum ventricular contractile force (r = .238 ± .074), whereas the effect of heart rate (r = −.015 ± .121) on thrombus formation is not significant.Conclusion: In conclusion, changes in ventricular systolic function may alter the risk of thrombotic events after EVAR repair, which could provide insight into the selection of adjuvant therapy strategies for AAA patients with CHD.

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Males with abdominal aortic aneurysm have reduced left ventricular systolic and diastolic function

Cited by 6 publications

References 25 publications

Abdominal aortic aneurysm influences the indices of arterial stiffness recorded by pulse wave analysis

Abdominal aortic aneurysm influences the indices of arterial stiffness recorded by pulse wave analysis

Wall shear stress and relative residence time as potential risk factors for abdominal aortic aneurysms in males: a 4D flow cardiovascular magnetic resonance caseâ€“control study

Effects of cardiac function alterations on the risk of postoperative thrombotic complications in patients receiving endovascular aortic repair

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