| Reduced systemic arterial compliance impacts significantly on left ventricular afterload and function in aortic stenosis: implications for diagnosis and treatment. | |
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MedLine Citation:
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PMID: 16022957 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: We sought to determine to what extent systemic arterial compliance (SAC) might impact on afterload and left ventricular (LV) function in patients with aortic stenosis (AS). BACKGROUND: Although AS and reduced SAC may often coexist in the same patient, their relative impact on LV function is not well understood. METHODS: Systemic arterial compliance was calculated as the ratio of stroke volume index to arterial pulse pressure in 208 patients with at least moderate AS. As a measure of global afterload, we calculated the valvulo-arterial impedance (Zva), which theoretically accounts for the effects of both AS and SAC. RESULTS: Patients were divided into four groups: group 1, moderate AS and normal SAC (n = 77; 37%); group 2, moderate AS and low SAC (n = 50; 24%); group 3, severe AS and normal SAC (n = 45; 22%); and group 4, severe AS and low SAC (n = 36; 17%). The prevalences of LV diastolic and systolic dysfunction were 60% and 6% in group 1, 86% and 12% in group 2, 82% and 16% in group 3, and 94% and 31% in group 4. In multivariate analysis excluding Zva, energy loss index and SAC were both independent predictors of LV dysfunction, but when Zva was entered into the analyses, it became the only hemodynamic variable to be independently associated with LV dysfunction. CONCLUSIONS: Reduced SAC is a frequent occurrence in elderly patients with AS, where it independently contributes to increased afterload and decreased LV function. Systemic arterial compliance should be taken into consideration when evaluating these patients with regard to diagnosis and treatment. |
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Authors:
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Martin Briand; Jean G Dumesnil; Lyes Kadem; Antonio G Tongue; Régis Rieu; Damien Garcia; Philippe Pibarot |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Journal of the American College of Cardiology Volume: 46 ISSN: 0735-1097 ISO Abbreviation: J. Am. Coll. Cardiol. Publication Date: 2005 Jul |
Date Detail:
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Created Date: 2005-07-18 Completed Date: 2005-08-05 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 8301365 Medline TA: J Am Coll Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: 291-8 Citation Subset: AIM; IM |
Affiliation:
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Research Group in Valvular Heart Diseases, Research Center of Laval Hospital/Quebec Heart Institute, Department of Medicine, Laval University, Sainte-Foy, Quebec, Canada. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Aortic Valve Stenosis / physiopathology* Arteries / physiopathology* Case-Control Studies Compliance Electrocardiography Female Hemodynamics / physiology Humans Male Multivariate Analysis Prevalence Pulse Retrospective Studies Stroke Volume / physiology Ventricular Dysfunction, Left / epidemiology*, physiopathology Ventricular Function, Left / physiology |
| Comments/Corrections | |
Comment In:
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J Am Coll Cardiol. 2005 Jul 19;46(2):299-301
[PMID:
16022958
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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