Arterial impedance as ventricular afterload.

Milnor, William R.

doi:10.1161/01.res.36.5.565

Cited by 356 publications

(140 citation statements)

References 33 publications

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“…In renal transplant recipients, arterial distensibility of large arteries is reduced and the impaired arterial buffering capacity seems to contribute to cardiovascular morbidity after renal transplantation. 4 There are no studies evaluating the mechanisms responsible for altered vessel wall properties in patients with renal failure. The present longitudinal investigation was aimed to evaluate the effects of hypertension on the mechanical vessel wall properties in renal transplant recipients.…”

Section: Discussionmentioning

confidence: 99%

“…1,2 The resultant impairment in buffering capacity on pulsatile pressure and the increased amplification of pressure wave reflected from the periphery can increase systolic pressure and left ventricular load and is associated with a higher cardiovascular risk. [1][2][3][4] Structural and mechanical properties of the arterial wall are altered in patients with renal failure. [5][6][7][8] It has been shown that the distensibility of large arteries is reduced in haemodialysis patients and in renal transplant recipients.…”

Section: Introductionmentioning

confidence: 99%

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A longitudinal study of vessel wall properties in normotensive and hypertensive renal transplant recipients

et al. 1998

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The mechanisms responsible for reduced arterial distensibility in renal transplant recipients remain to be evaluated. The present longitudinal study was aimed to evaluate the effect of hypertension on the evolution of vessel wall properties in renal transplant recipients. The mechanical properties of the common carotid artery were determined in 24 normotensive and 24 treated hypertensive renal transplant recipients 6-12 weeks after transplantation. The measurements were repeated after 2 years. Arterial distension was determined by using a multigate pulsed Doppler system, blood pressure (BP) was measured by a mercury sphygmomanometer. BP was 127 ؎ 3/80 ؎ 2 mm Hg at entry and 133 ؎ 3/82 ؎ 2 mm Hg after 2 years in the normotensive group, 146 ؎ 4/90 ؎ 3 mm Hg at entry and 145 ؎ 3/87 ؎ 2 mm Hg after 2 years in the hypertensive group (P Ͻ 0.01, normotensives vs hypertensives). The distens-

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A longitudinal study of vessel wall properties in normotensive and hypertensive renal transplant recipients

et al. 1998

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“…Formulated in terms of systolic developed pressure, it increased because left ventricular end-diastolic pressure fell significantly during the Mueller maneuver while the peak systolic pressure was maintained at baseline levels. Formulated in terms of systemic input impedance, 10 it increased because of a significant rise in the systemic vascular resistance, which represents the steady component of the afterload. We have previously shown that during the Mueller maneuver there is also a strong increase in the in-phase part of the overall systemic input impedance spectrum, which represents the pulsatile component of the afterload.…”

Section: Discussionmentioning

confidence: 99%

Hemodynamics of the Mueller maneuver in man: right and left heart micromanometry and Doppler echocardiography.

et al. 1987

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Ten subjects with normal hemodynamics were studied during elective cardiac catheterization with right and left heart multisensor micromanometry to assess hemodynamic responses to the Mueller maneuver. Simultaneous right and left circulatory hemodynamics and left ventricular, pulmonary arterial, and aortic pressures were recorded, in addition to pulmonary arterial and aortic flow velocities. Steady-state cardiac outputs were determined by thermal dilution. Aortic systolic and mean pressures were not significantly changed during the Mueller maneuver, in contrast to a lower diastolic (p = .019) and higher pulse pressure (p = .016). Mean right atrial pressure (± SE) decreased from 7 1 to -17 + 4 mm Hg (p = .0002) and the right atrial "x" descent was markedly accentuated. Left ventricular end-diastolic pressure decreased from 12 + 4 to -3 ± 13 mm Hg (p = .0025). Systemic vascular resistance and left ventricular peak positive dP/dt were increased during the Mueller maneuver (p < .02), cardiac output and stroke volume were reduced (p < .05), and there was no significant change in heart rate. Right and left peak flow velocities showed a trend toward a bilateral decrease (right, p = .054; left, p > .1), and times to peak flow velocity were increased in the pulmonary artery (p = .007) and reduced in the aortic root (p = .03). Normal subjects were studied separately by pulsed Doppler echocardiography. During the sustained Mueller maneuver, the internal jugular and right ventricular dimensions decreased, and superior vena cava Doppler flow was reduced. These data demonstrate reduced flow through the right and left heart chambers during a sustained Mueller maneuver in humans, in contrast to prior theory and animal data suggesting that right heart flow is increased during sustained forced inspiratory effort.

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“…Many epidemiological studies have demonstrated that PP is a major predictor of cardiovascular risk in the general population, 26,27) particularly in the elderly. 28,29) The increase in PP is an age-related phenomenon 28) and an indicator of large artery stiffness 29) ; this last condition increases afterload 30) and myocardial oxygen demand, impairs ventricular relaxation, and causes subendocardial ischemia even in the absence of CAD. 31) These effects make elderly people more prone to myocardial ischemia and ventricular dysfunction (ie.…”

Section: )mentioning

confidence: 99%

Predictors of Congestive Heart Failure Mortality in Elderly People From the General Population The CArdiovascular STudy in the ELderly (CASTEL)

et al. 2005

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SUMMARYCongestive heart failure (CHF) is highly prevalent in the elderly. The aim of this study was to identify the predictors of CHF mortality in patients over 65 years of age who were free of CHF at initial screening. A total of 3,282 elderly subjects were recruited in a population-based frame and 12-year events were recorded. Continuous items were divided into tertiles and for each tertile adjusted the relative risk (RR) with 95% confidence intervals (CI) was derived in both genders from multivariate Cox analysis of CHF mortality.Age

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Arterial impedance as ventricular afterload.

Cited by 356 publications

References 33 publications

A longitudinal study of vessel wall properties in normotensive and hypertensive renal transplant recipients

A longitudinal study of vessel wall properties in normotensive and hypertensive renal transplant recipients

Hemodynamics of the Mueller maneuver in man: right and left heart micromanometry and Doppler echocardiography.

Predictors of Congestive Heart Failure Mortality in Elderly People From the General Population The CArdiovascular STudy in the ELderly (CASTEL)

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