The effect of a dynamic increase in afterload on the first-phase ejection fraction

Cebrowska, Katarzyna; Mińczykowski, Andrzej; Guzik, Przemysław; Banaszak, Agnieszka; Wykrętowicz, Andrzej

doi:10.33963/kp.a2021.0041

Cited by 3 publications

(2 citation statements)

References 6 publications

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“…Alongside structural and functional changes that occur with aging and disease, P b exhibits an increased amplitude and/or a faster reflected wave transit time (RWTT), thereby arriving during systole and augmenting the P f , contributing to systolic hypertension (1)(2)(3)(4)(5). Increased afterload resulting from arterial wave reflection puts stress on cardiac tissue, reducing ejection fraction, stroke volume (SV), and overall left ventricular systolic function (6). Although wave reflections do have an essential cardiovascular function (i.e., enhanced coronary flow during diastole) (7), deviation from optimal conditions can lead to systemic pathology over time, making it a prime target for health interventions.…”

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confidence: 99%

Seated Elliptical Exercise, But Not Periodic Standing, Alleviates Sitting-Induced Changes to Arterial Wave Reflections

ATHAIDE,

ROBERTSON,

DEVRIES

et al. 2023

Medicine &Amp; Science in Sports &Amp; Exercise

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Purpose Sedentary behaviour may contribute to increased central wave reflection due to associated peripheral vasoconstriction, yet its impact on central hemodynamics and the mitigating effects of interventional strategies have not been thoroughly investigated. We tested whether standing, or seated elliptical breaks alleviate the deleterious effects of prolonged sitting on central wave reflections. Methods Eighteen healthy adults (9 females, 25 ± 3 years) completed three 3-hour protocols on separate days: uninterrupted sitting, sitting with periodic standing, and sitting with periodic seated elliptical activity. Central wave reflection, central pulse wave velocity and lower-limb pulse wave velocity were measured before and after each intervention. Results Central relative wave reflection magnitude (RM) increased during sitting (0.31 ± 0.05 to 0.35 ± 0.05; p < 0.01) but did not change following standing (0.30 ± 0.05 to 0.32 ± 0.04; p = 0.19) or elliptical protocols (0.30 ± 0.05 to 0.30 ± 0.04; p > 0.99). The change in RM during prolonged sitting (ΔRM) was attenuated with elliptical activity (0.04 ± 0.05 vs. 0.00 ± 0.03; p = 0.02) but not with periodic standing (0.04 ± 0.04 vs. 0.02 ± 0.05; p = 0.54). In addition, augmentation index and central pulse wave velocity increased following sitting (both p < 0.01) and periodic standing (both p < 0.01) but were unchanged following elliptical activity. Lower limb pulse wave velocity did not change following sitting (p = 0.73) or standing (p = 0.21) but did decrease following elliptical activity (p = 0.03). Conclusions Prolonged sitting without interruptions increased central wave reflection while elliptical but not standing interruptions were able to ameliorate multiple sitting-induced vascular consequences. More work is required to examine the long-term effectiveness of interruption strategies, as well as the optimal type, frequency, and duration for reducing vascular risk associated with sedentary behaviours.

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confidence: 99%

Seated Elliptical Exercise, But Not Periodic Standing, Alleviates Sitting-Induced Changes to Arterial Wave Reflections

ATHAIDE,

ROBERTSON,

DEVRIES

et al. 2023

Medicine &Amp; Science in Sports &Amp; Exercise

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“…59,60 Finally, augmentation of LV afterload in the setting of decreased left heart preload due to poor pulmonary venous return and ventricular interaction will further compromise systemic blood flow. 14,61 The adoption of certain pharmacologic treatments as a standard of care in neonatology, despite almost universal lack of benefit, is not unique to dopamine use. Use of prokinetics, H2-blockers, and diuretics represent examples of agents introduced with enthusiasm and presumed biologic merit, later found to be ineffective and potentially harmful in certain situations.…”

Section: Physiology-based Therapeutic Framework For Aphmentioning

confidence: 99%

Dopamine and Neonatal Pulmonary Hypertension—Pressing Need for a Better Pressor?

McNamara

Giesinger

Lakshminrusimha

2022

The Journal of Pediatrics

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First-Phase Left Ventricular Ejection Fraction as an Early Sign of Left Ventricular Dysfunction in Patients with Stable Coronary Artery Disease

Mińczykowski¹,

Zwanzig²,

Dziarmaga³

et al. 2023

JCM

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Left ventricular (LV) systolic function is often measured with echocardiography using LV ejection fraction (LVEF) or global longitudinal peak systolic strain (GLPSS). Global wasted work (GWW), global work efficiency (GWE), and first-phase ejection function (LVEF-1) are newer LV systolic function indices. We examined these parameters in 45 healthy individuals and 50 patients with stable coronary artery disease (CAD), normal LV contractility, and LVEF > 50%. Compared to healthy individuals, CAD patients had similar LVEF but increased GLPSS and GWW and reduced GWE and LVEF-1. The highest area under the receiver operating characteristic for detecting CAD was found for LVEF-1 (0.84; 95% CI 0.75–0.91; p < 0.0001), and it was significantly larger than for GLPSS (+0.166, p = 0.0082) and LVEF (+0.283, p = 00001). For LVEF-1 < 30%, the odds ratio for the presence of CAD was 22.67 (95% CI 6.47–79.44, p < 0.0001) in the logistic regression adjusted for age, sex, and body mass index. Finding LVEF-1 < 30% in an individual with normal LV myocardial contraction and preserved LVEF strongly suggests the presence of CAD.

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The effect of a dynamic increase in afterload on the first-phase ejection fraction

Cited by 3 publications

References 6 publications

Seated Elliptical Exercise, But Not Periodic Standing, Alleviates Sitting-Induced Changes to Arterial Wave Reflections

Seated Elliptical Exercise, But Not Periodic Standing, Alleviates Sitting-Induced Changes to Arterial Wave Reflections

Dopamine and Neonatal Pulmonary Hypertension—Pressing Need for a Better Pressor?

First-Phase Left Ventricular Ejection Fraction as an Early Sign of Left Ventricular Dysfunction in Patients with Stable Coronary Artery Disease

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