Effects of arterial distensibility on left ventricular ejection in the depressed contractile state

Maruyama, Yukio; Nishioka, Osama; Nozaki, Eiji; Kinoshita, Hiroshi; Kyono, Haruki; Koiwa, Yoshiro; Takishima, Tamotsu

doi:10.1093/cvr/27.2.182

Cited by 20 publications

(6 citation statements)

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“…Previous experimental studies have shown that re duced systemic arterial compliance may aggravate myo cardial ischemia in the presence of coronary artery steno sis [3] and impair left ventricular global systolic function in the presence of coronary artery ocelusion [2], In the present study, a moderate left ventricular dilatation was present after the 2.3 years of follow-up. Although this dila tation occurred concomitantly with the reduction in ar terial compliance, it was mild, and we did not find a sta tistically significant relation between the change in arteri al compliance and the change in left ventricular volume.…”

Section: Discussionsupporting

confidence: 58%

“…The mechanical properties of the systemic arteries determine left ventricular aftcrload and arc important for cardiac performance [1], A decreased aortic distensibility impairs left ventricular function [2] and aggravates myo cardial ischemia in the presence of a coronary artery ste nosis [3], Moreover, aortic distensibility is reduced in patients with coronary artery disease as compared to Supported by ti grant from the Norwegian Council on Cardiovaseular Dis eases (Oslo. Norway).…”

Section: Introductionmentioning

confidence: 99%

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Systemic Arterial Compliance Early and Late after a First Acute Myocardial Infarction

Aakhus

Bjørnstad²,

Soma³

et al. 1996

Cardiology

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Systemic arterial properties and left ventricular function were assessed by Doppler echocardiography and a calibrated subclavian artery pulse tracing early (5 weeks) and late (27 months) after a first acute myocardial infarction in 19 patients aged 44-77 years and in healthy subjects matched for age, gender, and arterial blood pressure. Total arterial compliance (3-element windkessel model) was reduced by 26% (p < 0.001) from early to late assessment, and left-ventricular end-diastolic and end-systolic volumes were increased by 11 and 18%, respectively (p < 0.05). Peripheral resistance and characteristic impedance were not significantly changed. The healthy matched subjects had arterial compliance similar to patients at early assessment, but tended to be higher at late. Thus, 2.3 years after a first acute myocardial infarction with moderate left ventricular dilatation, arterial distensibility was significantly decreased whereas peripheral resistance was not changed.

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Section: Discussionsupporting

confidence: 58%

Section: Introductionmentioning

confidence: 99%

Systemic Arterial Compliance Early and Late after a First Acute Myocardial Infarction

Aakhus

Bjørnstad²,

Soma³

et al. 1996

Cardiology

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“…(212) dyn.s.cm −5 , p < 0.0001), but caused no variation in mean pulmonary artery pressure (from 63 (20) to 64 (28) mm Hg, p = 0.67).…”

Section: Clinical and Haemodynamic Characteristicsmentioning

confidence: 87%

Intravascular ultrasound of the elastic pulmonary arteries: a new approach for the evaluation of primary pulmonary hypertension

Rodés‐Cabau

Domingo²,

Román³

et al. 2003

Heart

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Objective: To assess the structural and functional characteristics of pulmonary arteries by intravascular ultrasound (IVUS) in the setting of primary pulmonary hypertension, and to correlate the ultrasound findings with haemodynamic variables and mortality at follow up. Design: Prospective observational study. Setting: University hospital (tertiary referral centre). Patients: 20 consecutive patients with primary pulmonary hypertension (16 female; mean (SD) age, 39 (14) years). Methods: Cardiac catheterisation and simultaneous IVUS of pulmonary artery branches at baseline and after infusion of epoprostenol. Results: 33 pulmonary arteries with a mean diameter of 3.91 (0.80) mm were imaged, and wall thickening was observed in all cases, 64% being eccentric. Mean wall thickness was 0.37 (0.13) mm, percentage wall area 31.0 (9.3)%, pulsatility 14.6 (4.8)%, and pulmonary/elastic strain index 449 (174) mm Hg. No correlation was observed between IVUS findings and haemodynamic variables. Epoprostenol infusion increased pulsatility by 53% and decreased the pulmonary/elastic strain index by 41% (p = 0.0001), irrespective of haemodynamic changes. At 18 (12) months follow up, nine patients had died. A reduced pulsatility and an increased pulmonary/elastic strain index were associated with increased mortality at follow up ( Conclusions: IVUS demonstrated pulmonary artery wall abnormalities in all patients with primary pulmonary hypertension, mostly eccentric. The severity of the changes did not correlate with haemodynamic variables, and epoprostenol improved pulmonary vessel stiffness. There was an association between impaired pulmonary artery functional state as determined by IVUS and mortality at follow up. P rimary pulmonary hypertension is a life threatening disease characterised by a progressive increase in pulmonary blood pressure that often leads to right ventricular failure and death.1 Median survival is 2.8 years from the time of diagnosis, and mortality reaches 65% at three years of follow up.2 Calcium channel blockers, warfarin, and prostacyclin have improved the prognosis, but the three year mortality has remained as high as 50%. The diagnosis of primary pulmonary hypertension is based on clinical and haemodynamic data, and prognosis is determined by the alterations in haemodynamic variables (mean pulmonary artery pressure, cardiac output, mean right atrial pressure).The assessment of pulmonary artery morphology in primary pulmonary hypertension has been limited to pulmonary angiography and to the histological study of lung samples obtained at biopsy. Pulmonary angiography, which is not free of complications in these cases, only shows the vessel lumen and provides no information about vessel wall abnormalities. Histological evaluation of lung biopsies provides a valuable quantitative and qualitative description of the pulmonary wall changes, but remains a static in vitro examination without functional assessment and requires a thoracotomy. Intravascular ultrasound (IVUS) has been validated as a reliable method for...

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“…Diminished arterial distension may not reduce basal left ventricular function but does reduce the efficiency of cardiac contraction and the capacity to increase cardiac output. 9 Diminished arterial distension increases peak pressure but decreases peak aortic flow. 10 Large artery pulsation may also influence coronary flow.…”

Section: Arterial Interactionmentioning

confidence: 99%

Modulation of interaction between left ventricular ejection and the arterial compartment: assessment of aortic wave travel

et al. 2000

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Effects of arterial distensibility on left ventricular ejection in the depressed contractile state

Cited by 20 publications

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Systemic Arterial Compliance Early and Late after a First Acute Myocardial Infarction

Systemic Arterial Compliance Early and Late after a First Acute Myocardial Infarction

Intravascular ultrasound of the elastic pulmonary arteries: a new approach for the evaluation of primary pulmonary hypertension

Modulation of interaction between left ventricular ejection and the arterial compartment: assessment of aortic wave travel

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