Aortic elastic properties and left ventricular diastolic function in patients with Adamantiades-Behcet's disease

Ikonomidis, Ignatios; Lekakis, John; Stamatelopoulos, Kimon; Markomihelakis, Nikolaos; Kaklamanis, Phaedon; Mavrikakis, Myron

doi:10.1016/j.jacc.2003.10.042

Cited by 87 publications

(83 citation statements)

References 33 publications

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“…34 Studies have shown an association between increased indices of aortic stiffness and LV diastolic dysfunction in animal models, 12,27,34,35 in patients with CAD, 26 diabetes, 16 in obese subjects, 36 in treated hypertensive patients 13 and in patients with Adamantiades-Behcet syndrome. 10 However, to the best of our knowledge, we are the first to describe that in untreated patients with newly diagnosed hypertension, wave reflections are associated with LV diastolic dysfunction independently of age, gender, LVMI, AoS and BP parameters.…”

Section: Association Of Cai and Aos With LV Diastolic Dysfunctionmentioning

confidence: 83%

“…The following indices were measured from the mitral valve diastolic wave form: isovolumic relaxation time (IVRT; ms), peak early (E) and atrial (A) flow velocities (cm/sec), E/A ratio (the ratio of the mitral inflow velocities), decceleration time (DT; ms) of the LV diastolic filling using standard methodology. 10 Velocity time integral of the LV outflow tract velocity and LV outflow tract diameter were also measured to calculate the stroke volume (ml m À2 ). Flow propagation velocity (Fp; cm/sec) was measured by colour M-mode echocardiography in the apical four-chamber view.…”

Section: Echocardiography and Dopplermentioning

confidence: 99%

“…These observations suggest an association of systemic and local arterial properties with impaired Doppler diastolic indices and are in agreement with previous studies. [10][11][12]16 We also categorized our hypertensive patients into two groups: those with and those without LV diastolic dysfunction. Recently, it has been shown that arterial wave reflections are increased in patients with LV diastolic dysfunction who were referred for coronary angiography.…”

Section: Association Of Cai and Aos With LV Diastolic Dysfunctionmentioning

confidence: 99%

“…[8][9][10] Studies in humans have shown that hypertension may result in arterial stiffening, increased pulse wave velocity and thus, to the early arrival of the reflected waves. [3][4][5][6][7] In experimental studies, the early arrival of the wave reflections causes augmentation of the central systolic and reduction of the diastolic aortic pressure leading to the impairment of coronary perfusion and left ventricular (LV) diastolic function.…”

Section: Introductionmentioning

confidence: 99%

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Incremental value of arterial wave reflections in the determination of left ventricular diastolic dysfunction in untreated patients with essential hypertension

et al. 2008

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Systemic arterial stiffness is an indicator of cardiovascular disease and an independent marker of morbidity and cardiovascular mortality. We investigated the association of arterial wave reflections with left ventricular (LV) diastolic dysfunction and their incremental value to other determinants of LV diastolic dysfunction in patients with essential hypertension. In total 143 patients and 20 controls with similar atherosclerotic risk factors were examined by applanation tonometry of the radial artery (Sphygmocor) and echocardiography. Central augmentation index (CAI%) of reflected arterial waves as well as aortic strain (AoS) assessed by echocardiography were estimated. Doppler diastolic abnormalities were defined as proposed by the European Study Group on diastolic heart failure by measurement of E/A ratio (the ratio of the mitral inflow velocities), isovolumic relaxation time, deceleration time and flow propagation velocity. AoS and CAI were impaired in patients compared with controls (4.67 ± 2.94 vs 6.06 ± 4.91% and 145.8 ± 22.7 vs 135.7 ± 20.3%, Po0.01) as well as in patients with LV diastolic dysfunction compared to patients without, (5.52 ± 4.29 vs 10.73 ± 5.77% and 139.5 ± 21.7 vs 124.5 ± 17.0%, Po0.05). The odds ratio (OR) of AoS and CAI for diastolic dysfunction was OR:0.918, 95% confidence interval (CI):0.837-0.99, P ¼ 0.04 and OR:1.023, 95%CI: 1.023-1.040 P ¼ 0.010, respectively. The addition of CAI to the multivariable model including age, LV mass index, AoS and mean arterial pressure increased the power of the model for determination of LV diastolic dysfunction (À2 log likelihood ¼ 139.368, change of v 2 ¼ 4.2, P-value for change ¼ 0.04). In untreated patients with newly diagnosed essential hypertension, wave reflections are independent and additive determinants of LV diastolic dysfunction.

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Section: Association Of Cai and Aos With LV Diastolic Dysfunctionmentioning

confidence: 83%

Section: Echocardiography and Dopplermentioning

confidence: 99%

Section: Association Of Cai and Aos With LV Diastolic Dysfunctionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Incremental value of arterial wave reflections in the determination of left ventricular diastolic dysfunction in untreated patients with essential hypertension

et al. 2008

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“…The role of arterial stiffness in the development of CV diseases is well known [8]. In particular, the presence of arterial stiffness in large arteries, such as the aorta, has been reported to be the best predictor of CV morbidity and mortality [9].…”

Section: Introductionmentioning

confidence: 99%

Association between aortic stiffness and left ventricular function in inflammatory bowel disease

Aslan¹,

Sarı²,

Sarı³

et al. 2016

Cardiol J.

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The role of ventricular–arterial coupling in cardiac disease and heart failure: assessment, clinical implications and therapeutic interventions. A consensus document of the European Society of Cardiology Working Group on Aorta & Peripheral Vascular Diseases, European Association of Cardiovascular Imaging, and Heart Failure Association

Ikonomidis

Aboyans

Blacher³

et al. 2019

European J of Heart Fail

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244

243

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Ventricular–arterial coupling (VAC) plays a major role in the physiology of cardiac and aortic mechanics, as well as in the pathophysiology of cardiac disease. VAC assessment possesses independent diagnostic and prognostic value and may be used to refine riskstratification and monitor therapeutic interventions. Traditionally, VAC is assessed by the non‐invasive measurement of the ratio of arterial (Ea) to ventricular end‐systolic elastance (Ees). With disease progression, both Ea and Ees may become abnormal and the Ea/Ees ratio may approximate its normal values. Therefore, the measurement of each component of this ratio or of novel more sensitive markers of myocardial (e.g. global longitudinal strain) and arterial function (e.g. pulse wave velocity) may better characterize VAC. In valvular heart disease, systemic arterial compliance and valvulo–arterial impedance have an established diagnostic and prognostic value and may monitor the effects of valve replacement on vascular and cardiac function. Treatment guided to improve VAC through improvement of both or each one of its components may delay incidence of heart failure and possibly improve prognosis in heart failure. In this consensus document, we describe the pathophysiology, the methods of assessment as well as the clinical implications of VAC in cardiac diseases and heart failure. Finally, we focus on interventions that may improve VAC and thus modify prognosis.

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Aortic elastic properties and left ventricular diastolic function in patients with Adamantiades-Behcet's disease

Cited by 87 publications

References 33 publications

Incremental value of arterial wave reflections in the determination of left ventricular diastolic dysfunction in untreated patients with essential hypertension

Incremental value of arterial wave reflections in the determination of left ventricular diastolic dysfunction in untreated patients with essential hypertension

Association between aortic stiffness and left ventricular function in inflammatory bowel disease

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