Prognostic Value of Ventricular-Arterial Coupling and B-Type Natriuretic Peptide in Patients After Myocardial Infarction: A Five-Year Follow-Up Study

Antonini‐Canterin, Francesco; Enache, Roxana; Popescu, Bogdan A.; Popescu, Andreea C.; Ginghină, Carmen; Leiballi, Elisa; Piazza, Rita; Pavan, Daniela; Rubin, Daniela; Cappelletti, Piero; Nicolosi, Gian Luigi

doi:10.1016/j.echo.2009.08.009

Cited by 60 publications

(42 citation statements)

References 37 publications

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“…The hypertension-induced stiffening of both the heart and arteries in ESRD increases the workload imposed on the heart and consequently alters cardiac performance [2]. This may also alter the coupling of the left ventricle and vascular system, an important consideration as the ventricular-vascular interaction is associated with mortality [4] and can provide important information on cardiac load and energetics [5], but this outcome has not been fully explored in this population.…”

Section: Introductionmentioning

confidence: 99%

“…Appropriate ventricular and vascular matching is crucial in preventing exacerbated myocardial ischemia in response to reduced perfusion due to blood volume changes [5] and has been linked to survival post-infarction in patients with CVD [4]. Importantly, coronary flow reserve has already been shown to be compromised in ESRD, and functional capacity is also limited in other clinical populations by elevated Ea/Elv [12,13,14].…”

Section: Introductionmentioning

confidence: 99%

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Arterial Stiffness and Walk Time in Patients with End-Stage Renal Disease

Lane

Kistler

et al. 2013

Kidney Blood Press Res

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Background: End-stage renal disease patients experience increased prevalence of cardiovascular disease. Heart-artery interaction may be shifted, impacting blood pressure lability, and exercise tolerance. The coupling ratio consists of the ratio of indexed arterial elastance (EaI, arterial load) to ElvI, a measure of cardiac contractility or stiffness. Our purpose was to explore the relationship between elastances and functional capacity. We hypothesized that arterial stiffness (central pulse wave velocity, PWV) and elastances would be correlated to shuttle walk time. Methods: We used applanation tonometry, ultrasonography, and a shuttle walk test to evaluate our hypothesis. Spearman's correlations were used to assess relationships between variables. Block regression was also performed. Results: Forty-two subjects on maintenance hemodialysis participated. Average age=44±5 years, body surface area=2.01 kg/m². Mean EaI=4.45 and mean ElvI=6.89; the coupling ratio=0.82. Mean aortic pulse pressure=51 mmHg and PWV=9.6 m/s. PWV(r=-0.385) and EaI (r=-0.424) were significantly and inversely related to walking time while stroke volume index (SVI) was positively correlated to shuttle walk time (r=0.337), p<0.05 for all. Conclusions: We conclude that, like other clinical populations, both arterial and heart function predict walking ability and represent potential targets for intervention; arterial stiffness and SVI are strongly related to shuttle walk time in patients with ESRD.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Arterial Stiffness and Walk Time in Patients with End-Stage Renal Disease

Lane

Kistler

et al. 2013

Kidney Blood Press Res

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“…This approximation was originally described in a study involving 10 subjects using invasive measurements of SBP (12). Nevertheless, several studies used this approximation with noninvasive arm cuff blood pressure (1,4,6,20,22). Since the use of the Values are medians with interquartile ranges in parentheses; n, no.…”

Section: Discussionmentioning

confidence: 99%

“…For example, assessment of the effects of new drugs on contractility and C LV-A could prove useful as complementary information to the standard end points of LV performance (i.e., EF) routinely used in clinical trials. Another potential clinical use of the noninvasive assessment of the ventricular-arterial coupling is its predictive value for the outcomes of cardiovascular disease, as recently described in the context of myocardial infarction (1).…”

Section: Discussionmentioning

confidence: 99%

“…However, the feasibility of this noninvasive methodology was tested in only few clinical studies using two-dimensional (2D) echocardiography, combined with noninvasive estimates of end-systolic LV pressure. In addition, the reproducibility of this methodology is not well established (1,6,22). Moreover, there is a second theoretical approach, based on bilinear, rather than linear, approximation of the time-varying elastance curve, to calculate E es (24).…”

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confidence: 99%

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Noninvasive quantification of left ventricular elastance and ventricular-arterial coupling using three-dimensional echocardiography and arterial tonometry

Gayat

Mor‐Avi

Weinert

et al. 2011

American Journal of Physiology-Heart and Circulatory Physiology

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Gayat E, Mor-Avi V, Weinert L, Yodwut C, Lang RM. Noninvasive quantification of left ventricular elastance and ventricular-arterial coupling using three-dimensional echocardiography and arterial tonometry. Am J Physiol Heart Circ Physiol 301: H1916-H1923, 2011. First published September 9, 2011; doi:10.1152/ajpheart.00760.2011.-Most techniques previously used to assess left ventricular (LV) end-systolic elastance (E es) and ventricular-arterial coupling (CLV-A) relied on invasive measurements and data acquisition over a wide range of loading conditions. Our goals were to 1) assess the feasibility of noninvasive assessment of E es and CLV-A using real-time three-dimensional echocardiography (RT3DE) and arterial tonometry; 2) test the ability of this approach to detect changes in LV contractility; and 3) study its reproducibility. We studied pharmacologically induced changes in inotropic state (5 and 10 g·kg Ϫ1 ·min Ϫ1 dobutamine) in normal volunteers (N ϭ 8) and compared 10 normal volunteers with 10 patients with dilated cardiomyopathy (DCM; ejection fraction Ͻ 35%). RT3DE LV images, calibrated carotid artery tonometry, and Doppler tracings were obtained to noninvasively estimate Ees and CLV-A, using two alternative calculations. Dobutamine caused a significant stepwise increase in blood pressure, heart rate, ejection fraction, and Ees and a decreased CLV-A. In patients with DCM, Ees was significantly reduced and CLV-A elevated, compared with controls. Both inter-and intraobserver variability were good for all measured parameters, as reflected by intraclass correlation coefficients (Ͼ0.8) and coefficients of variation (Ͻ20%). While both Ees estimates showed significant differences between DCM patients and controls, one estimate resulted in no overlap and better reproducibility (interobserver intraclass correlation coefficient: 0.83 vs. 0.47, coefficients of variation: 20 vs. 29%). This is the first study to test the feasibility of using RT3DE-derived LV volumes in conjunction with arterial tonometry to noninvasively quantify LV elastance and CLV-A. This approach was found to be sensitive enough to detect expected differences in LV contractility and reproducible. Due to its noninvasive nature, this methodology may have clinical implications in various disease states. left ventricular contractility LEFT VENTRICULAR (LV) pressure-volume loops provide valuable information on LV systolic and diastolic function, as well as on LV-arterial coupling (C LV-A ) (8). End-systolic elastance (E es ), the slope of the end-systolic pressure (ESP)-volume relationship, has been used as a load-independent index of myocardial contractility (2). In the past, to obtain pressure-volume loops, invasive pressure and volume measurements were required to be obtained under a wide range of loading conditions, thus limiting the clinical applicability of this technique. To avoid these limitations, several investigators have proposed invasive solutions to estimate E es from a single cardiac cycle (23,24,27), and, more recently, the accuracy of ...

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Weight Gain, Hypertension, and the Emergence of a Maladaptive Cardiovascular Phenotype Among US Football Players

et al. 2019

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IMPORTANCE Former US football athletes are at increased risk of cardiovascular (CV) morbidity and mortality compared with the general population and other professional athletes. However, responsible maladaptive CV phenotypes have not been fully characterized.OBJECTIVE To address the emergence and progression of multiple independent factors associated with CV risk across serial years of collegiate US football participation. DESIGN, SETTING, AND PARTICIPANTS Collegiate US football athletes from 2 National Collegiate Athletic Association Division I programs were recruited as freshmen between June 2014 and June 2017 and analyzed at multiple points throughout 3 complete years of collegiate US football participation (until January 2019). Excluded athletes were those who did not complete any season of US football training because of injury, illness, or leaving the team. Factors associated with CV risk assessed clinically, by transthoracic echocardiography, and by vascular applanation tonometry were recorded. EXPOSURES The exposure of interest was seasonal US football exposure, including training, competition, and the training environment.MAIN OUTCOMES AND MEASURES Primary outcome measures were left ventricular mass index and geometry (cardiac structure), early diastolic myocardial relaxation velocity (E′; diastolic function), and pulse-wave velocity (arterial stiffness). RESULTS Of 186 individuals recruited as freshmen, 126 athletes were included in analyzed data. Collegiate US football athletes (62 white individuals [49%]; 63 black individuals [50%]; 77 nonlinemen [61%]; 49 linemen [39%]; 126 male individuals [100%]) weighed a mean (SD) of 101.1 (21.0) kg, with a mean systolic blood pressure of 129.1 (11.6) mm Hg at baseline of the freshman season. Adjusting for race, height, and player position, there were significant increases in weight (mean [SE] Δ, 4.

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Prognostic Value of Ventricular-Arterial Coupling and B-Type Natriuretic Peptide in Patients After Myocardial Infarction: A Five-Year Follow-Up Study

Cited by 60 publications

References 37 publications

Arterial Stiffness and Walk Time in Patients with End-Stage Renal Disease

Arterial Stiffness and Walk Time in Patients with End-Stage Renal Disease

Noninvasive quantification of left ventricular elastance and ventricular-arterial coupling using three-dimensional echocardiography and arterial tonometry

Weight Gain, Hypertension, and the Emergence of a Maladaptive Cardiovascular Phenotype Among US Football Players

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