| Arterial stiffness, central blood pressures, and wave reflections in cardiomyopathy-implications for risk stratification. | |
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MedLine Citation:
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PMID: 17602981 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: In general, pulse pressure (PP), augmentation index (AIx), and pulse wave velocity (PWV) are directly and positively associated with cardiovascular risk. However, in patients with systolic heart failure, the opposite (ie, an association between a lower PP and a worse outcome) has been reported as well. METHODS AND RESULTS: We assessed central PP and AIx, using applanation tonometry (SphygmoCor, AtCor Medical) in 63 patients with cardiomyopathy (CMP) and 126 controls, matched for age, gender, and brachial blood pressure (BP). All patients underwent coronary angiography for suspected coronary artery disease. In a subgroup (21 patients, 42 controls), we additionally measured aortic PWV invasively during catheter pullback. Mean age was 63.9 versus 64.1 years and ejection fraction (EF) was 29.9 versus 72.2% in patients versus controls, respectively. Calculated aortic systolic BP as well as invasively measured systolic BP was lower in patients versus controls. Central (but not peripheral) PP (33.8 versus 37.8 mm Hg, P = .01) and AIx (17.5 versus 23.3, P = .002) were lower and ejection duration was shorter (265 versus 314 ms, P < .00001) in patients as compared with controls. When we subdivided the CMP patients with respect to AIx, those with values below and equal to the median (median AIx = 17) had more advanced systolic dysfunction. In multiple regression analysis, EF was an independent predictor of AIx. PVW did not differ between CMP patients and controls (8.6 versus 8.2 m/s in patients versus controls, P = .43). Within the group of CMP patients, however, we observed a strong, positive correlation (r = 0.62, P = .003) between PWV and EF. CONCLUSIONS: Central PP, AIx, but also aortic PWV, key measures of arterial function, are susceptible to left ventricular performance. |
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Authors:
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Thomas Weber; Johann Auer; Gudrun Lamm; Michael F O'Rourke; Bernd Eber |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Journal of cardiac failure Volume: 13 ISSN: 1532-8414 ISO Abbreviation: J. Card. Fail. Publication Date: 2007 Jun |
Date Detail:
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Created Date: 2007-07-02 Completed Date: 2007-07-19 Revised Date: 2008-02-08 |
Medline Journal Info:
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Nlm Unique ID: 9442138 Medline TA: J Card Fail Country: United States |
Other Details:
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Languages: eng Pagination: 353-9 Citation Subset: IM |
Affiliation:
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Cardiology Department, Klinikum Kreuzschwestern Wels, Austria. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Arteries / pathology Blood Flow Velocity Blood Pressure Brachial Artery Cardiomyopathies / physiopathology* Coronary Angiography Diabetic Angiopathies / physiopathology Elasticity Female Humans Male Manometry Middle Aged Multivariate Analysis Myocardial Ischemia / physiopathology Pulsatile Flow / physiology Risk Assessment Vascular Resistance / physiology Ventricular Function, Left |
| Comments/Corrections | |
Comment In:
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J Card Fail. 2007 Nov;13(9):792
[PMID:
17996830
]
J Card Fail. 2007 Oct;13(8):694 [PMID: 17923364 ] |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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