| Elevated augmentation index derived from peripheral arterial tonometry is associated with abnormal ventricular-vascular coupling. | |
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MedLine Citation:
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PMID: 20545714 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Although typically derived from the contour of arterial pressure waveform, augmentation index (AIx) may also be derived from the digital pulse volume waveform using finger plethysmography (peripheral arterial tonometry, PAT). Little is known regarding the physiologic correlates of AIx derived from PAT. In this study, we investigated the relation of PAT-AIx with measures of ventricular-vascular coupling. METHODS: Pulse volume waves were measured via PAT and used to derive AIx. Using 2-dimensional echocardiography, effective arterial elastance index (EaI) was estimated as end-systolic pressure/stroke volume index. Left ventricular (LV) end-systolic elastance index (E(LV)I) was calculated as end-systolic pressure/end-systolic volume index. Ventricular-vascular coupling ratio was defined as EaI/E(LV)I. RESULTS: Given the bi-directional nature of ventricular-vascular uncoupling as measured by echocardiography, patients were separated into three groups: low EaI/E(LV)I (<0.6, n = 21), optimal EaI/E(LV)I (mean 0.6-1.2, n = 16) and high EaI/E(LV)I (>1.2, n = 10). Adjusting for potential confounders (age, mean arterial pressure, height and heart rate), patients with optimal EaI/E(LV)I had lower AIx (1 +/- 4%, P<0.05) compared to those with low EaI/E(LV)I (13 +/- 4%) and high EaI/E(LV)I (19 +/- 5%). CONCLUSIONS: Abnormal ventricular-vascular coupling, arising from either increased effective arterial elastance or increased ventricular elastance, is associated with increased AIx as measured by PAT. Additional research is needed to examine other vascular correlates of PAT-AIx. |
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Authors:
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Kevin S Heffernan; Eshan A Patvardhan; Michael Hession; Jenny Ruan; Richard H Karas; Jeffrey T Kuvin |
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Publication Detail:
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Type: Journal Article Date: 2010-06-10 |
Journal Detail:
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Title: Clinical physiology and functional imaging Volume: 30 ISSN: 1475-097X ISO Abbreviation: Clin Physiol Funct Imaging Publication Date: 2010 Sep |
Date Detail:
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Created Date: 2010-08-10 Completed Date: 2010-12-07 Revised Date: 2011-09-26 |
Medline Journal Info:
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Nlm Unique ID: 101137604 Medline TA: Clin Physiol Funct Imaging Country: England |
Other Details:
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Languages: eng Pagination: 313-7 Citation Subset: IM |
Affiliation:
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The Vascular Function Study Group, Division of Cardiology, Tufts Medical Center, Molecular Cardiology Research Institute, Boston, MA 02111, USA. KHeffernan@tuftsmedicalcenter.org |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Arteries
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physiopathology Blood Pressure* Chi-Square Distribution Diastole Echocardiography, Doppler Elasticity Female Fingers / blood supply* Humans Male Manometry* Middle Aged Plethysmography Predictive Value of Tests Stroke Volume Systole Ventricular Dysfunction, Left / physiopathology*, ultrasonography Ventricular Function, Left* Ventricular Pressure |
| Grant Support | |
ID/Acronym/Agency:
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T32 HL069770-06A1/HL/NHLBI NIH HHS |
| Comments/Corrections | |
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