Noninvasive Assessment of Myocardial Perfusion in Different Blood Pressure Phenotypes and Its Association With Arterial Stiffness Indices

Anyfanti, Panagiota; Gkaliagkousi, Εugenia; Triantafyllou, Αreti; Δίπλα, Κωνσταντίνα; Zarifis, Hippocrates; Arseniou, Polyvios; Lazaridis, Αntonios; Δούμα, Στέλλα

doi:10.1093/ajh/hpz039

Cited by 16 publications

(8 citation statements)

References 35 publications

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“…As expected, in our study, we observed a significant negative relation between SEVR and MAP (r = −0.301, p = 0.026), and a borderline negative relation with SBP (r = −0.257, p = 0.058). In line with previous studies, 11 , 20 , 34 our data support the hypothesis that arterial hypertension is strongly related to arterial stiffness and impaired subendocardial perfusion. The underlying mechanism is not completely clarified.…”

Section: Discussionsupporting

confidence: 93%

“… 8 DPTI, which is the area under the diastolic phase in the aortic profile, estimates myocardial oxygen supply, whereas SPTI (the area under the systolic phase) represents cardiac tissue oxygen consumption. 9 As previously described in patients with different hypertension phenotypes, 34 we suggest that SEVR may be considered a valid alternative to invasive assessment of microvascular coronary perfusion. Although, the relative lack of studies comparing SEVR values to other estimations of endocardial perfusion (by other cardiac imaging techniques) represents a possible limitation to the systematic use of SEVR, and further studies are needed.…”

Section: Discussionsupporting

confidence: 60%

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Impaired subendocardial perfusion in patients with metabolic syndrome

Fantin

Giani

Gasparini

et al. 2021

Diabetes and Vascular Disease Research

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Background Metabolic Syndrome (MS) is associated to vascular damage, increased arterial stiffness, and impaired myocardial perfusion. Subendocardial viability ratio (SEVR) is a noninvasive estimation of myocardial workload, oxygen supply, and perfusion. The aim of the study was to describe the relation between arterial stiffness, SEVR, and cardio-metabolic risk factors. Methods A cohort of 55 patients, aged 59.9 ± 10.8 years, was studied; 28 subjects (50.9%) had metabolic syndrome. All patients underwent a clinical evaluation and blood venous sampling, to assess glico-lipid profile. Applanation tonometry was performed, to obtain pulse wave analysis and SEVR values. Results In the overall study population, SEVR showed negative associations with mean (r = −0.301; p = 0.026) and systolic (borderline relation, r = −0.257; p = 0.058) arterial pressure. Metabolic syndrome patients presented lower level of SEVR ( p = 0.012), even after adjusting for age, sex, and mean arterial pressure ( p = 0.040). Subdividing the study population by the number of metabolic syndrome components, SEVR significantly decreased as the number of Metabolic Syndrome components increased ( p for trend 0.005). In a logistic backward regression analysis, both metabolic syndrome and mean arterial pressure resulted significant predictors of SEVR, accounting for 18% of variance. Conclusion The reduced SEVR in metabolic syndrome patients could be an important pathophysiological determinant of the increased cardiovascular risk.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 60%

Impaired subendocardial perfusion in patients with metabolic syndrome

Fantin

Giani

Gasparini

et al. 2021

Diabetes and Vascular Disease Research

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“…Anyfanti et al [ 50 ] also emphasize the usefulness of SEVR in assessing microvascular coronary perfusion as well as its variability according to blood pressure phenotype. SEVR varies according to blood pressure phenotype, and the group of investigators observed that normotensive patients have higher SEVR values compared to those with masked hypertension, white-coat hypertension or true hypertension ( p = 0.017).…”

Section: Discussionmentioning

confidence: 99%

Subendocardial Viability Ratio Predictive Value for Cardiovascular Risk in Hypertensive Patients

et al. 2022

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Background: The subendocardial viability ratio (SEVR), also known as the Buckberg index, is a parameter of arterial stiffness with indirect prognostic value in assessing long-term cardiovascular risk. Materials and Methods: We conducted a prospective cohort study on 70 patients with uncomplicated hypertension admitted to a county medical reference hospital. We analyzed demographics, laboratory data, arterial stiffness parameters and cardiovascular risk scores (SCORE and Framingham risk scores) and aimed to identify paraclinical parameters associated with increased cardiovascular risk. Results: Of the arterial stiffness parameters, SEVR correlates statistically significantly with age, central and peripheral systolic blood pressure, as well as with heart rate. SEVR seems to have prognostic value among hypertensive patients by increasing the risk of major cardiovascular events assessed by SCORE and Framingham risk scores. SEVR correlates statistically significantly with serum fibrinogen (p = 0.02) and hemoglobin (p = 0.046). Between pulse wave velocity and lipid parameters (p = 0.021 for low-density lipoprotein cholesterol <LDL> and p = 0.030 for triglycerides) a statistically significant relationship was found for the study group. The augmentation index of the aorta also correlated with serum LDL-cholesterol (p = 0.032) and the hemoglobin levels (p = 0.040) of hypertensive patients. Conclusions: Age, abdominal circumference and Framingham score are independent predictors for SEVR in our study group, further highlighting the need for early therapeutic measures to control risk factors in this category of patients.

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“…Arterial hypertension is characterised by diffuse microvascular damage (Fig. 3d, Figure 1, Supplemental Digital Content, http://links.lww.com/HJH/C223) [202][203][204][205][206]. Hypertension and inflammation have a bidirectional physiological and pathophysiological background [207,208].…”

Section: Arterial Hypertensionmentioning

confidence: 99%

The importance of microvascular inflammation in ageing and age-related diseases: a position paper from the ESH working group on small arteries, section of microvascular inflammation

Mengozzi

Ciuceis

Georgiopoulos

et al. 2023

Journal of Hypertension

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Microcirculation is pervasive and orchestrates a profound regulatory cross-talk with the surrounding tissue and organs. Similarly, it is one of the earliest biological systems targeted by environmental stressors and consequently involved in the development and progression of ageing and age-related disease. Microvascular dysfunction, if not targeted, leads to a steady derangement of the phenotype, which cumulates comorbidities and eventually results in a nonrescuable, very high-cardiovascular risk. Along the broad spectrum of pathologies, both shared and distinct molecular pathways and pathophysiological alteration are involved in the disruption of microvascular homeostasis, all pointing to microvascular inflammation as the putative primary culprit. This position paper explores the presence and the detrimental contribution of microvascular inflammation across the whole spectrum of chronic age-related diseases, which characterise the 21st-century healthcare landscape. The manuscript aims to strongly affirm the centrality of microvascular inflammation by recapitulating the current evidence and providing a clear synoptic view of the whole cardiometabolic derangement. Indeed, there is an urgent need for further mechanistic exploration to identify clear, very early or disease-specific molecular targets to provide an effective therapeutic strategy against the otherwise unstoppable rising prevalence of age-related diseases.

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Noninvasive Assessment of Myocardial Perfusion in Different Blood Pressure Phenotypes and Its Association With Arterial Stiffness Indices

Cited by 16 publications

References 35 publications

Impaired subendocardial perfusion in patients with metabolic syndrome

Impaired subendocardial perfusion in patients with metabolic syndrome

Subendocardial Viability Ratio Predictive Value for Cardiovascular Risk in Hypertensive Patients

The importance of microvascular inflammation in ageing and age-related diseases: a position paper from the ESH working group on small arteries, section of microvascular inflammation

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