Left Ventricle–Arterial System Interaction in Heart Failure

Abstract

Ejection fraction (EF) has been viewed as an important index in assessing the contractile state of the left ventricle (LV). However, it is frequently inadequate for the diagnosis and management of heart failure (HF), as a significant subset of HF patients have been found to have reduced EF (HFrEF) whereas others have preserved EF (HFpEF). It should be noted that the function of the LV is dependent on both preload and afterload, as well as its intrinsic contractile state. Furthermore, stroke volume (SV) is dependent on the properties of the arterial system (AS). Thus, the LV-arterial system interaction plays an important role in those patients with HF. This aspect is investigated through the analysis of the specific parameters involved in the coupling of the LV and AS. This includes contractility and the systolic/diastolic indices of the LV. Furthermore, AS afterload parameters such as vascular stiffness and arterial compliance, and their derived coupling coefficient, are also investigated. We conclude that those parameters, which relate to LV structural changes, are most appropriate in quantifying the LV–AS interaction.

A systemic congestive index (systemic pulse pressure to central venous pressure ratio) predicts adverse outcomes in patients undergoing valvular heart surgery

“…The cardiovascular system is intrinsically pulsatile in nature and is characterized by both ventricular-arterial and ventricular-ventricular interactions. [15][16][17] As shown in previous studies, ventricular-arterial interactions have been associated with adverse outcomes in patients undergoing cardiac surgery. 18 SPP is influenced by ventricular-arterial interactions and encompasses the combined effects of left ventricular contractile properties and arterial characteristics such as input impedance.…”

“…The cardiovascular system is intrinsically pulsatile in nature and is characterized by both ventricular‐arterial and ventricular‐ventricular interactions 15–17 . As shown in previous studies, ventricular‐arterial interactions have been associated with adverse outcomes in patients undergoing cardiac surgery 18 .…”

Ejection Fraction and Espvr: A Study in the Mechanics of Left Ventricular Contraction

“…For instance the influence of the geometry of the left ventricle on EF has been discussed by Dumesnil et al, possible influence of the geometry of the left ventricle on the ESPVR needs further consideration [20][21][22]. How coronary, valvular heart diseases or other cardiomyopathies affect the ESPVR is another subject that deserves attention [67][68][69].…”

Primary media sclerosis Mönckeberg: Diagnostic criteria

“…The clinical relevance of media sclerosis Mönckeberg (MSM) relates largely to three major issues. First, stiffening of the large conducting arteries increases the workload of the heart and may contribute to heart failure in the long run [1,2]. Second, calcifi cation of the micro-vessels [3] may impair blood pressure regulation and organ perfusion.…”