The Correlation of Carotid Artery Stiffness with Heart Function in Hypertensive Patients

Myung, Yusik; Seo, Hye Sun; Jung, In Mok; Lee, Nae Hee; Suh, Jon; Choi, Jae Huk; Cho, Yoon Haeng

doi:10.4250/jcu.2012.20.3.134

Cited by 26 publications

(26 citation statements)

References 30 publications

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“…In accordance with our study, a recent meta‐analysis reported that the prevalence of LV hypertrophy was about 3‐fold greater in patients with LA enlargement than those without . Additionally, investigators have shown that LA diameter is independently associated with arterial stiffness, which may affect the development of LV diastolic dysfunction. Furthermore, in patients with HFnEF, common comorbidities such as coronary artery disease, diabetes mellitus, obesity, and renal dysfunction may result in volume overload and myocardial injury of atrium .…”

Section: Discussionsupporting

confidence: 91%

Left Atrial Enlargement in the Early Stage of Hypertensive Heart Disease: A Common But Ignored Condition

et al. 2014

J of Clinical Hypertension

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How to identify the early signs of hypertensive heart disease is the key to block or reverse the process of heart failure. The aim of this study was to evaluate the predictive value of left atrial (LA) enlargement in the early stage of hypertensive heart disease and to explore the correlations between LA enlargement and heart failure with normal ejection fraction (HFnEF), as well as the metabolic syndrome (MetS). Baseline clinical characteristics, biochemical indices, electrocardiographic and echocardiographic data were collected from 341 consecutive patients with essential hypertension. Among those patients, LA enlargement was more frequently presented than LV enlargement (57.2% vs 17.9%). Compared with patients without HFnEF, the prevalence of LA enlargement was higher in patients with HFnEF (82.9% vs 49.0%, P<.0001). From grade 2 to grade 3 hypertension, LA size was significantly larger in patients with MetS (P<.01) than those without. Multivariate linear regression analyses showed that age, body mass index, waist circumference, triglyceride level, and left ventricular diameter were independent predictors of LA enlargement. The simple measurement for identification of LA enlargement potentially allows early recognition of those patients at risk for heart failure, particularly among patients with MetS. J Clin Hypertens (Greenwich). 2014;16:192-197. ª2014 Wiley Periodicals, Inc.Recent epidemiological data show that more than 200 million adults present with hypertension in China, which was found as the second leading cause of heart failure. From hypertension to hypertensive heart disease is a slow and progressive process, and persistent high pressure load may lead to compensatory left ventricular (LV) hypertrophy. LV hypertrophy or enlargement confirmed by electrocardiography (ECG) or echocardiography is about 10% to 30% in unselected hypertensive patients. Previous studies 1 have shown that echocardiographic left atrial (LA) enlargement occurring before LV hypertrophy is an early sign of hypertensive heart disease. LA volume provides a sensitive morphophysiologic expression of the severity of LV diastolic dysfunction, and appears to be a useful index of cardiovascular risk and disease burden, and LA volume indexed to body surface is independently associated with outcome of cardiovascular diseases.2 A report by Nicolaou and colleagues 3 has recently revealed that the metabolic syndrome (MetS) increases LA diameter in paroxysmal atrial fibrillation patients and obesity was an important covariate of LA size in hypertensive patients. However, the prevalence of LA enlargement and its correlation to heart failure with normal ejection fraction (HFnEF) and MetS have not been assessed in Chinese hypertensive patients.The aims of the present study were 3-fold: (1) to investigate the prevalence of LA enlargement in patients with essential hypertension; (2) to assess the relationship between LA enlargement and HFnEF, as well as MetS; and (3) to explore independent predictors of LA enlargement.

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Section: Discussionsupporting

confidence: 91%

Left Atrial Enlargement in the Early Stage of Hypertensive Heart Disease: A Common But Ignored Condition

et al. 2014

J of Clinical Hypertension

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“…Previous studies attempted to report the relationship between atherosclerotic CVD and arterial strain. Indeed, several studies documented that the changes in elastic properties due to aging or cardiovascular RFs could be successfully evaluated with carotid strain values that were acquired using the speckle tracking method . In addition, another recent study showed that circumferential strain and strain rate were significantly correlated with a previous stroke event .…”

Section: Discussionsupporting

confidence: 67%

“…Indeed, several studies documented that the changes in elastic properties due to aging or cardiovascular RFs could be successfully evaluated with carotid strain values that were acquired using the speckle tracking method. 6,7,13 In addition, another recent study showed that circumferential strain and strain rate were significantly correlated with a previous stroke event. 14 Our present study's findings expand on these data by demonstrating the feasibility of assessing circumferential and radial movements of the CCA in both transverse and longitudinal carotid B-mode ultrasonograms to determine the relationship to atherothrombotic stroke.…”

Section: Discussionmentioning

confidence: 99%

Assessment of multidirectional movements of the common carotid artery in atherothrombotic stroke using dimensional speckle tracking carotid ultrasonography: A prospective, controlled cohort study

Yoon¹,

Han²,

Kim³

et al. 2018

Echocardiography

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“…Measures of the CCA stiffness have been associated with risk of ischemic stroke and dementia but not of coronary artery disease [14,15,16,17,18]. However, with advancing age, disproportionately increased proximal aortic stiffness may match the stiffness of CCA [14], reduce the impedance mismatch, and tighten the link between CCA stiffness and LV structure and function [9,19]. In this context, measures of the CCA stiffness may become a surrogate for ascending aortic stiffness and provide additional information on the pathogenesis of heart failure beyond cf-PWV, an index of arterial aging [9,20].…”

Section: Introductionmentioning

confidence: 99%

Common Carotid Artery Stiffness Is Associated with Left Ventricular Structure and Function and Predicts First Hospitalization for Acute Heart Failure

Sung¹,

Liao²,

Yu³

et al. 2014

Pulse

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Aims: Proximal aortic stiffness may be more important than carotid-femoral pulse wave velocity (cf-PWV) in the pathogenesis of heart failure. The present study investigated the associations of common carotid artery (CCA) stiffness, which might be a surrogate for proximal aortic stiffness, with left ventricular (LV) structure and function, and the development of acute heart failure (AHF). Methods and Results: Outpatients without a history of heart failure (114 subjects aged 63.5 ± 17.5 years) were enrolled for comprehensive noninvasive cardiovascular examinations. The LV mass index, the LV ejection fraction (EF), and the ratio of the early diastolic transmitral flow velocity to the early septal mitral annular diastolic velocity (E/E') were measured by echocardiography. CCA mechanical properties, including the incremental elastic modulus (Einc), β stiffness index, CCA distensibility (CD) and circumferential strain (CS), were assessed by carotid artery ultrasonography. cf-PWV was measured by arterial tonometry. CD was significantly associated with the LV mass index, and all CCA stiffness indices were significantly associated with EF and E/E' independently of age, mean blood pressure, and cf-PWV. During a mean follow-up of 265 ± 106 days, 9 patients presented with AHF. Einc (hazard ratio 6.56, 95% confidence interval 1.64-26.26, by quartile analysis), CS (6.82, 1.70-27.35), and β stiffness index (3.91, 1.05-14.57) but not cf-PWV (1.62, 0.41-6.51) significantly predicted the events. Conclusions: In patients at risk for heart failure, CCA stiffness was significantly associated with LV structure and function independently of cf-PWV. In addition, CCA stiffness but not cf-PWV predicted first AHF. © 2014 S. Karger AG, Basel

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The Correlation of Carotid Artery Stiffness with Heart Function in Hypertensive Patients

Cited by 26 publications

References 30 publications

Left Atrial Enlargement in the Early Stage of Hypertensive Heart Disease: A Common But Ignored Condition

Left Atrial Enlargement in the Early Stage of Hypertensive Heart Disease: A Common But Ignored Condition

Assessment of multidirectional movements of the common carotid artery in atherothrombotic stroke using dimensional speckle tracking carotid ultrasonography: A prospective, controlled cohort study

Common Carotid Artery Stiffness Is Associated with Left Ventricular Structure and Function and Predicts First Hospitalization for Acute Heart Failure

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