Ventricular–vascular coupling in hypertension

Saba, Pier Sergio; Cameli, Matteo; Casalnuovo, Giuseppina; Ciccone, Marco Matteo; Ganau, Antonello; Maiello, Maria; Modesti, Pietro Amedeo; Muiesan, María Lorenza; Novo, Salvatore; Palmiero, Pasquale; Sanna, Giuseppe D; Scicchitano, Pietro; Pedrinelli, Roberto

doi:10.2459/jcm.0000000000000146

Cited by 21 publications

(12 citation statements)

References 151 publications

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“…The fact that elevated wave reflections and central blood pressure augmentation can be normalized with dilating as compared with nondilating antihypertensive drugs [1, 13, 14] demonstrates that the enhanced wave reflections are not due to fixed structural entities. The increase in wave reflections after beta-blockade observed in both the N and P groups of this and a previous study [15] is consistent with previous results implicating modulation by the autonomic nervous system [3, 16]. There is also increasing evidence for a role of the endothelium in the elevation of wave reflections.…”

Section: Discussionsupporting

confidence: 92%

“…We used this categorization to avoid the vagaries associated with categorizing based on the blood pressure at the time of the procedure but doing so may have made delineation of the categories a bit uncertain. Third, there are many noninvasive methods to estimate central aortic pressure and flow [3–6]. Each of these, however, entails an approximation, assumption, or mathematical transformation which has been validated but still engenders a certain degree of uncertainty.…”

Section: Discussionmentioning

confidence: 99%

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Arterial Hemodynamics in Prehypertensives

Ting

Chen

Chang

et al. 2019

International Journal of Hypertension

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Compared to age-matched normotensive adults, those with essential hypertension have been shown to have distinct arterial hemodynamic abnormalities consisting of increased peripheral resistance, pulse wave velocity, and wave reflection magnitude as well as decreased wave reflection time and aortic compliance. These abnormalities are further exacerbated by beta-adrenergic blockade. To see if there are similar hemodynamic abnormalities that antedate the onset of fixed hypertension, we compared age-matched normotensives with prehypertensives selected from patients undergoing diagnostic cardiac catheterization. Ascending aortic pressure and flow were measured with a micromanometer and flow velocity sensor in the baseline state and after beta-adrenergic blockade. In the baseline state the prehypertensive compared to the normotensive group had elevated blood pressure, resistance, left ventricular end-diastolic pressure (LVEDP), and wave reflections. Beta-adrenergic blockade increased resistance, LVEDP, and wave reflections in both groups. Some of these findings are the same as those we previously reported in young persons with established, essential hypertension. The differences in LVEDP and wave reflections, both in the baseline state and after beta-blockade, were still present in subgroups with no differences in blood pressure. Hence, the elevated wave reflections in prehypertensives do not appear to be directly related to the level of blood pressure. These results support the notion that the elevated blood pressure in hypertension may represent a later manifestation of an already abnormal vascular system rather than the vascular abnormalities resulting from hypertension. Consequently, even before blood pressure becomes elevated, early diagnosis and treatment of the vascular abnormalities in prehypertensives may be warranted.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Arterial Hemodynamics in Prehypertensives

Ting

Chen

Chang

et al. 2019

International Journal of Hypertension

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“…39 Also, as reflected on the terminology of ventricular-vascular coupling, structural and functional alterations of the arterial system are known to adversely impact left ventricular function and structure, which could limit functional capacity. 39, 40 …”

Section: Discussionmentioning

confidence: 99%

Ankle-brachial index and physical function in older individuals: The Atherosclerosis Risk in Communities (ARIC) study

et al. 2017

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Background and aims Most prior studies investigating the association of lower extremity peripheral artery disease (PAD) with physical function were small or analyzed selected populations (e.g., patients at vascular clinics or persons with reduced function), leaving particular uncertainty regarding the association in the general community. Methods Among 5,262 ARIC participants (age 71-90 years during 2011-2013), we assessed the cross-sectional association of ankle-brachial index (ABI) with the Short Physical Performance Battery (SPPB) score (0-12), its individual components (chair stands, standing balance, and gait speed) (0-4 points each), and grip strength after accounting for potential confounders, including a history of coronary disease, stroke, or heart failure. Results There were 411 participants (7.8%) with low ABI ≤0.90 and 469 (8.9%) participants with borderline low ABI 0.91-1.00. Both ABI ≤0.90 and 0.91-1.00 were independently associated with poor physical function (SPPB score ≤6) compared to ABI 1.11-1.20 (adjusted odds ratio 2.10 [95% CI 1.55-2.84] and 1.86 [1.38-2.51], respectively). The patterns were largely consistent across subgroups by clinical conditions (e.g., leg pain or other cardiovascular diseases), in every SPPB component, and for grip strength. ABI >1.3 (472 participants [9.0%]), indicative of non-compressible pedal arteries, was related to lower physical function as well but did not necessarily reach significance. Conclusions In community-dwelling older adults, low and borderline low ABI suggestive of PAD were independently associated with poorer systemic physical function compared to those with normal ABI. Clinical attention to PAD as a potential contributor to poor physical function is warranted in community-dwelling older adults.

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“…A maximum effort should be considered to obtain a good ventricular-vascular coupling. Different drugs are used for this purpose and some others are being investigated [1,2]. Particularly challenging is to achieve an adequate perfusion in a dissecting aorta.…”

Section: Discussionmentioning

confidence: 99%

Dacron Graft Axillary Infection after Aortic Dissection Surgery

2015

J Vasc Med Surg

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Peripheral cannulation is required to have an adequate perfusion in patients undergoing cardiac surgery due to an aortic dissection. Many surgeons use the axillary artery to perfuse the patient using a tube graft sutured to the axillary artery. The purpose of this technique is to have more control of the surgical field. We described the case of a patient who developed a decubitus of the axillary Dacron graft six month after surgery.

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Ventricular–vascular coupling in hypertension

Cited by 21 publications

References 151 publications

Arterial Hemodynamics in Prehypertensives

Arterial Hemodynamics in Prehypertensives

Ankle-brachial index and physical function in older individuals: The Atherosclerosis Risk in Communities (ARIC) study

Dacron Graft Axillary Infection after Aortic Dissection Surgery

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