Document Detail


Arterial wave reflection and subclinical left ventricular systolic dysfunction.
MedLine Citation:
PMID:  21169863     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: Increased arterial wave reflection is a predictor of cardiovascular events and has been hypothesized to be a cofactor in the pathophysiology of heart failure. Whether increased wave reflection is inversely associated with left-ventricular (LV) systolic function in individuals without heart failure is not clear.
METHODS: Arterial wave reflection and LV systolic function were assessed in 301 participants from the Cardiovascular Abnormalities and Brain Lesions (CABL) study using two-dimensional echocardiography and applanation tonometry of the radial artery to derive central arterial waveform by a validated transfer function. Aortic augmentation index (AIx) and wasted energy index (WEi) were used as indices of wave reflection. LV systolic function was measured by LV ejection fraction (LVEF) and tissue Doppler imaging (TDI). Mitral annulus peak systolic velocity (Sm), peak longitudinal strain and strain rate were measured. Participants with history of coronary artery disease, atrial fibrillation, LVEF less than 50% or wall motion abnormalities were excluded.
RESULTS: Mean age of the study population was 68.3 ± 10.2 years (64.1% women, 65% hypertensive). LV systolic function by TDI was lower with increasing wave reflection, whereas LVEF was not. In multivariate analysis, TDI parameters of LV longitudinal systolic function were significantly and inversely correlated to AIx and WEi (P values from 0.05 to 0.002).
CONCLUSIONS: In a community cohort without heart failure and with normal LVEF, an increased arterial wave reflection was associated with subclinical reduction in LV systolic function assessed by novel TDI techniques. Further studies are needed to investigate the prognostic implications of this relationship.
Authors:
Cesare Russo; Zhezhen Jin; Yasuyoshi Takei; Takuya Hasegawa; Shun Koshaka; Vittorio Palmieri; Mitchell Sv Elkind; Shunichi Homma; Ralph L Sacco; Marco R Di Tullio
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  Journal of hypertension     Volume:  29     ISSN:  1473-5598     ISO Abbreviation:  J. Hypertens.     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-02-14     Completed Date:  2011-06-16     Revised Date:  2014-09-20    
Medline Journal Info:
Nlm Unique ID:  8306882     Medline TA:  J Hypertens     Country:  England    
Other Details:
Languages:  eng     Pagination:  574-82     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Arteries / physiology*
Cardiovascular Diseases / etiology
Cohort Studies
Female
Humans
Male
Middle Aged
Stroke Volume
Systole*
Ultrasonography, Doppler, Color
Ventricular Dysfunction, Left / etiology*
Ventricular Function, Left
Grant Support
ID/Acronym/Agency:
R01 NS036286/NS/NINDS NIH HHS; R01 NS036286-10/NS/NINDS NIH HHS; R01 NS36286/NS/NINDS NIH HHS; R37 NS029993/NS/NINDS NIH HHS; R37 NS029993-16/NS/NINDS NIH HHS; R37 NS29993/NS/NINDS NIH HHS
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