Arterial Stiffness and Coronary Ischemia: New Aspects and Paradigms

Vallée, Alexandre; Cinaud, Alexandre; Protogerou, Athanase D.; Zeng, Yi; Topouchian, Jirar; Safar, Michel E.; Blacher, Jacques

doi:10.1007/s11906-019-1006-z

Cited by 26 publications

(24 citation statements)

References 68 publications

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“…Another finding of our study is that in multivariable regression analysis, the number of affected vessels, detected at the time of PPCI, was significantly and independently associated with PWV. This observation underscores the validity of our data and is in line with previous findings, where a close relationship between PWV and the extent of coronary artery disease has been observed [ 35 , 36 ].…”

Section: Discussionsupporting

confidence: 94%

Determinants and prognostic relevance of aortic stiffness in patients with recent ST-elevation myocardial infarction

Lechner

Reindl

Tiller

et al. 2021

Int J Cardiovasc Imaging

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The association between aortic stiffness, cardiovascular risk factors and prognosis in patients with recent ST-elevation myocardial infarction (STEMI) is poorly understood. We analyzed the relationship between cardiovascular risk factors and arterial stiffening and assessed its prognostic significance in patients with recent STEMI. We prospectively enrolled 408 consecutive patients who sustained a first STEMI and underwent primary percutaneous coronary intervention (PPCI). Aortic pulse wave velocity (PWV), the most widely used measure of aortic stiffness, was determined by the transit-time method using velocity-encoded, phase-contrast cardiac magnetic resonance imaging. Patient characteristics were acquired at baseline and major adverse cardiac and cerebrovascular events (MACCE) were assessed at 13 [interquartile range (IQR) 12–31] months. Cox regression- and logistic regression analysis were performed to explore predictors of aortic stiffness and MACCE. Median aortic PWV was 6.6 m/s (IQR 5.6–8.3 m/s). In multivariable analysis, age [odds ratio (OR) 1.10, 95% confidence interval (CI), 1.08–1.14, p < 0.001] and hypertension (OR 2.45, 95% CI, 1.53–3.91, p < 0.001) were independently associated with increased PWV. Sex, diabetes, smoking status, dyslipidemia, and obesity were not significantly associated with PWV in adjusted analysis (all p > 0.05). High PWV significantly and independently predicted occurrence of MACCE in adjusted analysis [hazard ratio (HR) 2.45, 95% CI 1.19–5.04, p = 0.014]. In patients with recent STEMI, the impact of classical cardiovascular risk factors on aortic stiffness is mainly dependent on age and increased blood pressure. Increased aortic stiffness is associated with adverse clinical outcome post-STEMI, suggesting it as a relevant therapeutic target in this population. Trial (NCT04113356).

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Section: Discussionsupporting

confidence: 94%

Determinants and prognostic relevance of aortic stiffness in patients with recent ST-elevation myocardial infarction

Lechner

Reindl

Tiller

et al. 2021

Int J Cardiovasc Imaging

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“…AS can be an integrator of long-lasting arterial wall damage leading to luminal dilation due to an increase in collagen deposition ( 8 ). It is associated with coronary atherosclerosis ( 9 ), CV events ( 10 ), and inflammatory disorders ( 11 ).…”

Section: Introductionmentioning

confidence: 99%

Association Between Lipids and Arterial Stiffness for Primary Cardiovascular Prevention in a General Middle-Aged European Population

Vallée

2022

Front. Cardiovasc. Med.

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BackgroundDyslipidemia contributes to the progression of arterial stiffness (AS). The purpose of this study was to investigate the association of the different lipid parameters with arterial stiffness index (ASI) in a middle-aged population free of cardiovascular (CV) disease.MethodsAmong 71,326 volunteers from the UK Biobank population, total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL), high-density lipoprotein cholesterol (HDL), lipoprotein (a) [Lp(a)], apolipoproteins A and B (Apo A and Apo B), and ASI were measured. Values for non-HDL, TC/HDL, TG/HDL, and LDL/HDL were calculated. AS was defined as an ASI > 10 m/s. Associations between lipid parameters and ASI were performed using multiple linear logistic regressions. The results reported from univariate models were the squared partial correlation coefficient, r2, and from multivariate models, the adjusted coefficient of determination, R2, to describe the contribution of ASI variability for each lipid parameter.ResultsWe found that TG/HDL was mainly associated with ASI [β = 0.53 (0.01), r2 = 3.66%, p < 0.001 and adjusted β = 0.21 (0.01), R2 = 13.58%, p < 0.001] and AS [odds ratio (OR) = 1.86 (1.80–1.92), r2 = 1.65%, p < 0.001 and adjusted OR = 1.15 (1.13–1.17), R2 = 8.54%, p < 0.001] rather than the others. TG/HDL remained the only lipid parameter that showed added value in linear multivariate models. TG/HDL remained less associated with AS than age (r2 = 5.55%, p < 0.001), mean blood pressure (BP; r2 = 5.31%, p < 0.001), and gender (r2 = 4.44%, p < 0.001), but more highly associated than body mass index (BMI; r2 = 1.95%, p < 0.001), heart rate (HR; r2 = 0.81%, p < 0.001), fasting glucose (r2 = 0.18%, p < 0.001), tobacco (r2 = 0.05%, p < 0.001), and glomerular filtration rate (GFR; r2 = 0.01%, p < 0.001).ConclusionsIn primary CV prevention, lipids, especially through the TG/HDL ratio, could be more instructive in preventing the increase in AS than other modifiable factors.

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“…Moreover, AoSBP and AIx decreased after AE and CE, which is suggestive of reduced systemic arterial stiffness. Individuals with higher BP usually exhibit greater levels of arterial stiffness 1 . In people with elastic arteries, the reflected wave travels backward slowly (against the blood flow direction) and arrives at the aortic root during late systole or early diastole, which favors the filling of coronary vessels 37 .…”

Section: Discussionmentioning

confidence: 99%

Effects of aerobic, resistance and concurrent exercise on pulse wave reflection and autonomic modulation in men with elevated blood pressure

Farinatti

Itaborahy

Paula

et al. 2021

Sci Rep

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The acute effects of exercise modes on pulse wave reflection (PWR) and their relationship with autonomic control remain undefined, particularly in individuals with elevated blood pressure (BP). We compared PWR and autonomic modulation after acute aerobic (AE), resistance (RE), and concurrent exercise (CE) in 15 men with stage-1 hypertension (mean ± SE: 34.7 ± 2.5 years, 28.4 ± 0.6 kg/m2, 133 ± 1/82 ± 2 mmHg). Participants underwent AE, RE, and CE on different days in counterbalanced order. Applanation tonometry and heart rate variability assessments were performed before and 30-min postexercise. Aortic pressure decreased after AE (− 2.4 ± 0.7 mmHg; P = 0.01), RE (− 2.2 ± 0.6 mmHg; P = 0.03), and CE (− 3.1 ± 0.5 mmHg; P = 0.003). Augmentation index remained stable after RE, but lowered after AE (− 5.1 ± 1.7%; P = 0.03) and CE (− 7.6 ± 2.4% P = 0.002). Systolic BP reduction occurred after CE (− 5.3 ± 1.9 mmHg). RR-intervals and parasympathetic modulation lowered after all conditions (~ 30–40%; P < 0.05), while the sympathovagal balance increased after RE (1.2 ± 0.3–1.3 ± 0.3 n.u., P < 0.05). Changes in PWR correlated inversely with sympathetic and directly with vagal modulation in CE. In conclusion, AE, RE, and CE lowered central aortic pressure, but only AE and CE reduced PWR. Overall, those reductions related to decreased parasympathetic and increased sympathetic outflows. Autonomic fluctuations seemed to represent more a consequence than a cause of reduced PWR.

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Arterial Stiffness and Coronary Ischemia: New Aspects and Paradigms

Cited by 26 publications

References 68 publications

Determinants and prognostic relevance of aortic stiffness in patients with recent ST-elevation myocardial infarction

Determinants and prognostic relevance of aortic stiffness in patients with recent ST-elevation myocardial infarction

Association Between Lipids and Arterial Stiffness for Primary Cardiovascular Prevention in a General Middle-Aged European Population

Effects of aerobic, resistance and concurrent exercise on pulse wave reflection and autonomic modulation in men with elevated blood pressure

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