Document Detail

Carotid arterial stiffness and its relationship to exercise intolerance in older patients with heart failure and preserved ejection fraction.
MedLine Citation:
PMID:  23150511     Owner:  NLM     Status:  MEDLINE    
Heart failure with a preserved ejection fraction (HFpEF) is the dominant form of heart failure in the older population. The primary chronic symptom in HFpEF is severe exercise intolerance; however, its pathophysiology and therapy are not well understood. We tested the hypothesis that older patients with HFpEF have increased arterial stiffness beyond what occurs with normal aging and that this contributes to their severe exercise intolerance. Sixty-nine patients ≥60 years of age with HFpEF and 62 healthy volunteers (24 young healthy subjects ≤30 years and 38 older healthy subjects ≥60 years old) were examined. Carotid arterial stiffness was assessed using high-resolution ultrasound, and peak exercise oxygen consumption was measured using expired gas analysis. Peak exercise oxygen consumption was severely reduced in the HFpEF patients compared with older healthy subjects (14.1±2.9 versus 19.7±3.7 mL/kg per minute; P<0.001) and in both was reduced compared with young healthy subjects (32.0±7.2 mL/kg per minute; both P<0.001). In HFpEF compared with older healthy subjects, carotid arterial distensibility was reduced (0.97±0.45 versus 1.33±0.55×10(-3) mm Hg(-1); P=0.008) and Young's elastic modulus was increased (1320±884 versus 925±530 kPa; P<0.02). Carotid arterial distensibility was directly (0.28; P=0.02) and Young's elastic modulus was inversely (-0.32; P=0.01) related to peak exercise oxygen consumption. Carotid arterial distensibility is decreased in HFpEF beyond the changes attributed to normal aging and is related to peak exercise oxygen consumption. This supports the hypothesis that increased arterial stiffness contributes to exercise intolerance in HFpEF and is a potential therapeutic target.
Dalane W Kitzman; David M Herrington; Peter H Brubaker; J Brian Moore; Joel Eggebeen; Mark J Haykowsky
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2012-11-12
Journal Detail:
Title:  Hypertension     Volume:  61     ISSN:  1524-4563     ISO Abbreviation:  Hypertension     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2012-12-13     Completed Date:  2013-02-27     Revised Date:  2014-01-10    
Medline Journal Info:
Nlm Unique ID:  7906255     Medline TA:  Hypertension     Country:  United States    
Other Details:
Languages:  eng     Pagination:  112-9     Citation Subset:  IM    
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MeSH Terms
Aged, 80 and over
Carotid Arteries / physiopathology*,  ultrasonography
Carotid Artery Diseases / physiopathology*,  ultrasonography
Carotid Intima-Media Thickness
Exercise / physiology
Exercise Test
Exercise Tolerance / physiology*
Heart Failure / physiopathology*,  ultrasonography
Middle Aged
Oxygen Consumption
Stroke Volume / physiology*
Vascular Stiffness / physiology*
Ventricular Function, Left / physiology
Grant Support
P30 AG021332/AG/NIA NIH HHS; P30-AG021332/AG/NIA NIH HHS; R37 AG018915/AG/NIA NIH HHS; R37-AG18915/AG/NIA NIH HHS

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