| Arterial pulsatile hemodynamic load induced by isometric exercise strongly predicts left ventricular mass in hypertension. | |
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MedLine Citation:
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PMID: 19966060 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Although resting hemodynamic load has been extensively investigated as a determinant of left ventricular (LV) hypertrophy, little is known about the relationship between provoked hemodynamic load and the risk of LV hypertrophy. We studied central pressure-flow relations among 40 hypertensive and 19 normotensive adults using carotid applanation tonometry and Doppler echocardiography at rest and during a 40% maximal voluntary forearm contraction (handgrip) maneuver. Carotid-femoral pulse wave velocity (CF-PWV) was measured at rest. Hypertensive subjects demonstrated various abnormalities in resting and induced pulsatile load. Isometric exercise significantly increased systemic vascular resistance, aortic characteristic impedance (Zc), induced earlier wave reflections, increased augmentation index, and decreased total arterial compliance (TAC; all P < or = 0.01). In hypertensive subjects, CF-PWV was the strongest resting predictor of LV mass index (LVMI) and remained an independent predictor after adjustment for age, gender, systemic vascular resistance, reflection magnitude, aortic Zc, and TAC (beta = 2.52 m/s; P < 0.0001). Age, sex, CF-PWV, and resting hemodynamic indexes explained 48% of the interindividual variability in LVMI. In stepwise regression, TAC (beta = -17.85; P < 0.0001) during handgrip, Zc during handgrip (beta = -150; P < 0.0001), and the change in the timing of wave reflections during handgrip (beta = -0.63; P = 0.03) were independent predictors of LVMI. A model that included indexes of provoked hemodynamic load explained 68% of the interindividual variability in LVMI. Hemodynamic load provoked by isometric exercise strongly predicts LVMI in hypertension. The magnitude of this association is far greater than for resting hemodynamic load, suggesting that provoked testing captures important arterial properties that are not apparent at rest and is advantageous to assess dynamic arterial load in hypertension. |
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Authors:
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Julio A Chirinos; Patrick Segers; Amresh Raina; Hassam Saif; Abigail Swillens; Amit K Gupta; Raymond Townsend; Anthony G Emmi; James N Kirkpatrick; Martin G Keane; Victor A Ferrari; Susan E Wiegers; Martin G St John Sutton |
Publication Detail:
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Type: Journal Article Date: 2009-12-04 |
Journal Detail:
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Title: American journal of physiology. Heart and circulatory physiology Volume: 298 ISSN: 1522-1539 ISO Abbreviation: Am. J. Physiol. Heart Circ. Physiol. Publication Date: 2010 Feb |
Date Detail:
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Created Date: 2010-01-21 Completed Date: 2010-02-16 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 100901228 Medline TA: Am J Physiol Heart Circ Physiol Country: United States |
Other Details:
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Languages: eng Pagination: H320-30 Citation Subset: IM |
Affiliation:
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University of Pennsylvania, Philadelphia Veterans Affairs Medical Center, Philadelphia, PA 19104, USA. Julio.chirinos@uphs.upenn.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Aged, 80 and over Blood Pressure / physiology* Cardiac Output / physiology Carotid Arteries / physiopathology* Case-Control Studies Echocardiography, Three-Dimensional Exercise / physiology* Fatigue / physiopathology Female Hand Strength / physiology Heart Rate / physiology Heart Ventricles / pathology, physiopathology Humans Hypertension / complications*, physiopathology Hypertrophy, Left Ventricular / pathology, physiopathology, ultrasonography* Male Manometry Middle Aged Predictive Value of Tests Regional Blood Flow / physiology* Stroke Volume / physiology |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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