Resynchronization improves heart-arterial coupling reducing arterial load determinants
Cardiac resynchronization therapy (CRT) has benefits on left ventricle (LV) performance, but its mid-term effects on LV load and LV-arterial coupling are unknown. To evaluate CRT mid-term effects on LV-arterial coupling, arterial load and its determinants, and the association between CRT-dependent a...
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| Veröffentlicht in: | Europace (London, England) England), 2013-04, Vol.15 (4), p.554-565 |
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| creator | Zócalo, Yanina Bia, Daniel Armentano, Ricardo L González-Moreno, Juan Varela, Gonzalo Calleriza, Fernando Reyes-Caorsi, Walter |
| description | Cardiac resynchronization therapy (CRT) has benefits on left ventricle (LV) performance, but its mid-term effects on LV load and LV-arterial coupling are unknown.
To evaluate CRT mid-term effects on LV-arterial coupling, arterial load and its determinants, and the association between CRT-dependent aortic haemodynamic changes and the arterial biomechanics.
Cardiac and aortic echographies were done in 25 patients (age: 61 ± 12 years; 14 men; New York Heart Association functional classes III-IV; LV ejection fraction = 28 ± 7%, QRS = 139 ± 20 ms) before and after (23 ± 12 days) CRT. Standard structural and functional parameters and dyssynchrony indices were evaluated. Ascending aorta flow and diameter waveforms were measured. Central pressure was derived using a transfer function and the diameter calibration method. Calculus: arterial elastance (EA); aortic impedance (Zc) and distensibility (AD); systemic resistances (SVR), total compliance (CT); global reflection coefficient; LV end-systolic elastance (EES); and LV-arterial coupling (EA/EES). After CRT EA diminished (-30%;P = 0.001), EES increased (29%; P = 0.001) and EA/EES improved (pre-CRT: 2.9 ± 0.9, post-CRT: 1.6 ± 0.7; P = 0.001). Arterial elastance changes were associated with changes in arterial properties. Cardiac resynchronization therapy was associated with pressure-independent increase in mean aortic diameter (pre-CRT: 30.0 ± 4.0 mm, post-CRT: 33.0 ± 5.1 mm; P = 0.005) and distensibility (pre-CRT: 3.8 ± 2.6 × 10(-3)mmHg(-1), post-CRT: 6.4 ± 2.5 × 10(-3) mmHg(-1); P = 0.002), and Zc reduction (pre-CRT: 3.5 ± 1.8 × 10(-2)mmHg.s/mL, post-CRT:1.9 ± 0.8 × 10(-2) mmHg.s/mL; P = 0.001) and SVR (pre-CRT:1.7 ± 0.4 mmHg.s/mL, post-CRT:1.0 ± 0.3 mmHg.s/mL; P = 0.001). Changes in EA determinants were associated with changes in aortic flow.
Early after CRT central and peripheral arterial biomechanics improved, determining a pressure-independent increase in aortic diameter and a reduction in arterial load. Left ventricular systolic performance and LV-arterial coupling were enhanced. Arterial biomechanical changes were associated with aortic flow changes. |
| doi_str_mv | 10.1093/europace/eus285 |
| format | Article |
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To evaluate CRT mid-term effects on LV-arterial coupling, arterial load and its determinants, and the association between CRT-dependent aortic haemodynamic changes and the arterial biomechanics.
Cardiac and aortic echographies were done in 25 patients (age: 61 ± 12 years; 14 men; New York Heart Association functional classes III-IV; LV ejection fraction = 28 ± 7%, QRS = 139 ± 20 ms) before and after (23 ± 12 days) CRT. Standard structural and functional parameters and dyssynchrony indices were evaluated. Ascending aorta flow and diameter waveforms were measured. Central pressure was derived using a transfer function and the diameter calibration method. Calculus: arterial elastance (EA); aortic impedance (Zc) and distensibility (AD); systemic resistances (SVR), total compliance (CT); global reflection coefficient; LV end-systolic elastance (EES); and LV-arterial coupling (EA/EES). After CRT EA diminished (-30%;P = 0.001), EES increased (29%; P = 0.001) and EA/EES improved (pre-CRT: 2.9 ± 0.9, post-CRT: 1.6 ± 0.7; P = 0.001). Arterial elastance changes were associated with changes in arterial properties. Cardiac resynchronization therapy was associated with pressure-independent increase in mean aortic diameter (pre-CRT: 30.0 ± 4.0 mm, post-CRT: 33.0 ± 5.1 mm; P = 0.005) and distensibility (pre-CRT: 3.8 ± 2.6 × 10(-3)mmHg(-1), post-CRT: 6.4 ± 2.5 × 10(-3) mmHg(-1); P = 0.002), and Zc reduction (pre-CRT: 3.5 ± 1.8 × 10(-2)mmHg.s/mL, post-CRT:1.9 ± 0.8 × 10(-2) mmHg.s/mL; P = 0.001) and SVR (pre-CRT:1.7 ± 0.4 mmHg.s/mL, post-CRT:1.0 ± 0.3 mmHg.s/mL; P = 0.001). Changes in EA determinants were associated with changes in aortic flow.
Early after CRT central and peripheral arterial biomechanics improved, determining a pressure-independent increase in aortic diameter and a reduction in arterial load. Left ventricular systolic performance and LV-arterial coupling were enhanced. Arterial biomechanical changes were associated with aortic flow changes.</description><identifier>ISSN: 1099-5129</identifier><identifier>EISSN: 1532-2092</identifier><identifier>DOI: 10.1093/europace/eus285</identifier><identifier>PMID: 23143859</identifier><language>eng</language><publisher>England</publisher><subject>Aged ; Aorta - diagnostic imaging ; Aorta - physiopathology ; Arterial Pressure ; Biomechanical Phenomena ; Blood Pressure ; Cardiac Resynchronization Therapy ; Echocardiography, Doppler ; Elasticity ; Female ; Heart Failure - diagnosis ; Heart Failure - physiopathology ; Heart Failure - therapy ; Heart Rate ; Hemodynamics ; Humans ; Linear Models ; Male ; Middle Aged ; Models, Cardiovascular ; Predictive Value of Tests ; Stroke Volume ; Time Factors ; Treatment Outcome ; Vascular Resistance ; Ventricular Function, Left</subject><ispartof>Europace (London, England), 2013-04, Vol.15 (4), p.554-565</ispartof><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c404t-6bcda9ed8a48464c0a3b31bc911e244e0860b040edf0898a3ffb0391fbb23d7c3</citedby><cites>FETCH-LOGICAL-c404t-6bcda9ed8a48464c0a3b31bc911e244e0860b040edf0898a3ffb0391fbb23d7c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,778,782,27907,27908</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23143859$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Zócalo, Yanina</creatorcontrib><creatorcontrib>Bia, Daniel</creatorcontrib><creatorcontrib>Armentano, Ricardo L</creatorcontrib><creatorcontrib>González-Moreno, Juan</creatorcontrib><creatorcontrib>Varela, Gonzalo</creatorcontrib><creatorcontrib>Calleriza, Fernando</creatorcontrib><creatorcontrib>Reyes-Caorsi, Walter</creatorcontrib><title>Resynchronization improves heart-arterial coupling reducing arterial load determinants</title><title>Europace (London, England)</title><addtitle>Europace</addtitle><description>Cardiac resynchronization therapy (CRT) has benefits on left ventricle (LV) performance, but its mid-term effects on LV load and LV-arterial coupling are unknown.
To evaluate CRT mid-term effects on LV-arterial coupling, arterial load and its determinants, and the association between CRT-dependent aortic haemodynamic changes and the arterial biomechanics.
Cardiac and aortic echographies were done in 25 patients (age: 61 ± 12 years; 14 men; New York Heart Association functional classes III-IV; LV ejection fraction = 28 ± 7%, QRS = 139 ± 20 ms) before and after (23 ± 12 days) CRT. Standard structural and functional parameters and dyssynchrony indices were evaluated. Ascending aorta flow and diameter waveforms were measured. Central pressure was derived using a transfer function and the diameter calibration method. Calculus: arterial elastance (EA); aortic impedance (Zc) and distensibility (AD); systemic resistances (SVR), total compliance (CT); global reflection coefficient; LV end-systolic elastance (EES); and LV-arterial coupling (EA/EES). After CRT EA diminished (-30%;P = 0.001), EES increased (29%; P = 0.001) and EA/EES improved (pre-CRT: 2.9 ± 0.9, post-CRT: 1.6 ± 0.7; P = 0.001). Arterial elastance changes were associated with changes in arterial properties. Cardiac resynchronization therapy was associated with pressure-independent increase in mean aortic diameter (pre-CRT: 30.0 ± 4.0 mm, post-CRT: 33.0 ± 5.1 mm; P = 0.005) and distensibility (pre-CRT: 3.8 ± 2.6 × 10(-3)mmHg(-1), post-CRT: 6.4 ± 2.5 × 10(-3) mmHg(-1); P = 0.002), and Zc reduction (pre-CRT: 3.5 ± 1.8 × 10(-2)mmHg.s/mL, post-CRT:1.9 ± 0.8 × 10(-2) mmHg.s/mL; P = 0.001) and SVR (pre-CRT:1.7 ± 0.4 mmHg.s/mL, post-CRT:1.0 ± 0.3 mmHg.s/mL; P = 0.001). Changes in EA determinants were associated with changes in aortic flow.
Early after CRT central and peripheral arterial biomechanics improved, determining a pressure-independent increase in aortic diameter and a reduction in arterial load. Left ventricular systolic performance and LV-arterial coupling were enhanced. Arterial biomechanical changes were associated with aortic flow changes.</description><subject>Aged</subject><subject>Aorta - diagnostic imaging</subject><subject>Aorta - physiopathology</subject><subject>Arterial Pressure</subject><subject>Biomechanical Phenomena</subject><subject>Blood Pressure</subject><subject>Cardiac Resynchronization Therapy</subject><subject>Echocardiography, Doppler</subject><subject>Elasticity</subject><subject>Female</subject><subject>Heart Failure - diagnosis</subject><subject>Heart Failure - physiopathology</subject><subject>Heart Failure - therapy</subject><subject>Heart Rate</subject><subject>Hemodynamics</subject><subject>Humans</subject><subject>Linear Models</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Models, Cardiovascular</subject><subject>Predictive Value of Tests</subject><subject>Stroke Volume</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><subject>Vascular Resistance</subject><subject>Ventricular Function, Left</subject><issn>1099-5129</issn><issn>1532-2092</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNo9kMtLw0AQxhdRbK2evUmOXmJnH3nsUYovKAiiXsM-JnYlydbdRKh_vSl9HIb5hvnmY_gRck3hjoLkcxyCXyuDo4iszE7IlGacpQwkOx01SJlmlMkJuYjxGwAKJrNzMmGcCl5mcko-3zBuOrMKvnN_qne-S1y7Dv4XY7JCFfp0LAxONYnxw7px3VcS0A5mK46rxiubWByn1nWq6-MlOatVE_Fq32fk4_HhffGcLl-fXhb3y9QIEH2aa2OVRFsqUYpcGFBcc6qNpBSZEAhlDhoEoK2hlKXida2BS1przbgtDJ-R213u-PLPgLGvWhcNNo3q0A-xopwBzVlRwGid76wm-BgD1tU6uFaFTUWh2sKsDjCrHczx4mYfPugW7dF_oMf_AXvAdcI</recordid><startdate>20130401</startdate><enddate>20130401</enddate><creator>Zócalo, Yanina</creator><creator>Bia, Daniel</creator><creator>Armentano, Ricardo L</creator><creator>González-Moreno, Juan</creator><creator>Varela, Gonzalo</creator><creator>Calleriza, Fernando</creator><creator>Reyes-Caorsi, Walter</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20130401</creationdate><title>Resynchronization improves heart-arterial coupling reducing arterial load determinants</title><author>Zócalo, Yanina ; Bia, Daniel ; Armentano, Ricardo L ; González-Moreno, Juan ; Varela, Gonzalo ; Calleriza, Fernando ; Reyes-Caorsi, Walter</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c404t-6bcda9ed8a48464c0a3b31bc911e244e0860b040edf0898a3ffb0391fbb23d7c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Aged</topic><topic>Aorta - diagnostic imaging</topic><topic>Aorta - physiopathology</topic><topic>Arterial Pressure</topic><topic>Biomechanical Phenomena</topic><topic>Blood Pressure</topic><topic>Cardiac Resynchronization Therapy</topic><topic>Echocardiography, Doppler</topic><topic>Elasticity</topic><topic>Female</topic><topic>Heart Failure - diagnosis</topic><topic>Heart Failure - physiopathology</topic><topic>Heart Failure - therapy</topic><topic>Heart Rate</topic><topic>Hemodynamics</topic><topic>Humans</topic><topic>Linear Models</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Models, Cardiovascular</topic><topic>Predictive Value of Tests</topic><topic>Stroke Volume</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><topic>Vascular Resistance</topic><topic>Ventricular Function, Left</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Zócalo, Yanina</creatorcontrib><creatorcontrib>Bia, Daniel</creatorcontrib><creatorcontrib>Armentano, Ricardo L</creatorcontrib><creatorcontrib>González-Moreno, Juan</creatorcontrib><creatorcontrib>Varela, Gonzalo</creatorcontrib><creatorcontrib>Calleriza, Fernando</creatorcontrib><creatorcontrib>Reyes-Caorsi, Walter</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Europace (London, England)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Zócalo, Yanina</au><au>Bia, Daniel</au><au>Armentano, Ricardo L</au><au>González-Moreno, Juan</au><au>Varela, Gonzalo</au><au>Calleriza, Fernando</au><au>Reyes-Caorsi, Walter</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Resynchronization improves heart-arterial coupling reducing arterial load determinants</atitle><jtitle>Europace (London, England)</jtitle><addtitle>Europace</addtitle><date>2013-04-01</date><risdate>2013</risdate><volume>15</volume><issue>4</issue><spage>554</spage><epage>565</epage><pages>554-565</pages><issn>1099-5129</issn><eissn>1532-2092</eissn><abstract>Cardiac resynchronization therapy (CRT) has benefits on left ventricle (LV) performance, but its mid-term effects on LV load and LV-arterial coupling are unknown.
To evaluate CRT mid-term effects on LV-arterial coupling, arterial load and its determinants, and the association between CRT-dependent aortic haemodynamic changes and the arterial biomechanics.
Cardiac and aortic echographies were done in 25 patients (age: 61 ± 12 years; 14 men; New York Heart Association functional classes III-IV; LV ejection fraction = 28 ± 7%, QRS = 139 ± 20 ms) before and after (23 ± 12 days) CRT. Standard structural and functional parameters and dyssynchrony indices were evaluated. Ascending aorta flow and diameter waveforms were measured. Central pressure was derived using a transfer function and the diameter calibration method. Calculus: arterial elastance (EA); aortic impedance (Zc) and distensibility (AD); systemic resistances (SVR), total compliance (CT); global reflection coefficient; LV end-systolic elastance (EES); and LV-arterial coupling (EA/EES). After CRT EA diminished (-30%;P = 0.001), EES increased (29%; P = 0.001) and EA/EES improved (pre-CRT: 2.9 ± 0.9, post-CRT: 1.6 ± 0.7; P = 0.001). Arterial elastance changes were associated with changes in arterial properties. Cardiac resynchronization therapy was associated with pressure-independent increase in mean aortic diameter (pre-CRT: 30.0 ± 4.0 mm, post-CRT: 33.0 ± 5.1 mm; P = 0.005) and distensibility (pre-CRT: 3.8 ± 2.6 × 10(-3)mmHg(-1), post-CRT: 6.4 ± 2.5 × 10(-3) mmHg(-1); P = 0.002), and Zc reduction (pre-CRT: 3.5 ± 1.8 × 10(-2)mmHg.s/mL, post-CRT:1.9 ± 0.8 × 10(-2) mmHg.s/mL; P = 0.001) and SVR (pre-CRT:1.7 ± 0.4 mmHg.s/mL, post-CRT:1.0 ± 0.3 mmHg.s/mL; P = 0.001). Changes in EA determinants were associated with changes in aortic flow.
Early after CRT central and peripheral arterial biomechanics improved, determining a pressure-independent increase in aortic diameter and a reduction in arterial load. Left ventricular systolic performance and LV-arterial coupling were enhanced. Arterial biomechanical changes were associated with aortic flow changes.</abstract><cop>England</cop><pmid>23143859</pmid><doi>10.1093/europace/eus285</doi><tpages>12</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Aged Aorta - diagnostic imaging Aorta - physiopathology Arterial Pressure Biomechanical Phenomena Blood Pressure Cardiac Resynchronization Therapy Echocardiography, Doppler Elasticity Female Heart Failure - diagnosis Heart Failure - physiopathology Heart Failure - therapy Heart Rate Hemodynamics Humans Linear Models Male Middle Aged Models, Cardiovascular Predictive Value of Tests Stroke Volume Time Factors Treatment Outcome Vascular Resistance Ventricular Function, Left |
| title | Resynchronization improves heart-arterial coupling reducing arterial load determinants |
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