Ventricular-arterial coupling in case of chronic heart failure with preserved and reduced left ventricular ejection fraction

Dikur O.N.; Poltavskaya M.G.; Giverts I.Iu.; Doletskiĭ A.A.; Pesheva O.V.; Syrkin A.L.

doi:https://doi.org/

Dikur O.N.

Kafedra profilakticheskoĭ i neotlozhnoĭ kardiologii IPO Pervogo MGMU im. I.M. Sechenova

Poltavskaya M.G.

Sechenov First Moscow State Medical University, Moscow, Russia

Giverts I.Iu.

GBOU VPO "Pervyĭ MGMU im. I.M. Sechenova" Minzdrava Rossii;
kafedra profilakticheskoĭ i neotlozhnoĭ kardiologii FPPOV Pervogo MGMU im. I.M. Sechenova, klinika kardiologii

Doletskiĭ A.A.

GOU VPO Pervyĭ MGMU im. I.M. Sechenova Minzdrava Rossii

Pesheva O.V.

Kafedra profilakticheskoĭ i neotlozhnoĭ kardiologii IPO Pervogo MGMU im. I.M. Sechenova

Syrkin A.L.

Sechenov First Moscow State Medical University

Scopus AuthorID: 7103104759
ORCID: 0000-0002-9602-292X

Ventricular-arterial coupling in case of chronic heart failure with preserved and reduced left ventricular ejection fraction

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Dikur O.N., Poltavskaya M.G., Giverts I.Iu., Doletskiĭ A.A., Pesheva O.V., Syrkin A.L.

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Journal: Russian Journal of Cardiology and Cardiovascular Surgery. 2014;7(4): 59‑68

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Dikur ON, Poltavskaya MG, Giverts IIu, Doletskiĭ AA, Pesheva OV, Syrkin AL. Ventricular-arterial coupling in case of chronic heart failure with preserved and reduced left ventricular ejection fraction. Russian Journal of Cardiology and Cardiovascular Surgery. 2014;7(4):59‑68. (In Russ.)

Подписка 2026 Кардиология и сердечно-сосудистая хирургия (Russian Journal of Cardiology and Cardiovascular Surgery)

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Abstract:

It is presented detailed review of studies of myocardial and great arteries stiffness, features of ventricular-arterial coupling disorders in patients with chronic heart failure (CHF) and preserved left ventricular ejection fraction (CHF-PEF). The own research data are also presented. The study included 50 patients with chronic heart failure and low ejection fraction (HF-LEF), 41 patients with CHF-PEF and 32 patients with arterial hypertension (AH). It was performed contour analysis of pulse wave and calculation of end-systolic (Ees) and arterial elasticity (Ea), effective ventricular-arterial coupling (Ea/Ees). Patients with CHF-LEF demonstrated the highest stiffness index of large arteries - 10.7±3.0 m/s and the index of reflection of muscular type small arteries - 46.9%. In patients with CHF-PEF and arterial hypertension these figures were significantly lower - 9.2±3.2 m/s and 33.5%; 9.1±2.8 m/s and 33.5%, respectively. Average value of augmentation index in patients with CHF-PEF was significantly higher than in other groups (13.9% vs 8.2% for hypertension and 11.1% in CHF-LEF). Parameters Ea and Ees were significantly higher than normal values in patients with CHF-PEF and exceeded conforming figures in patients with CHF-LEF (2.91±0.88 vs. 2.18±0.98 and 4.67±2.06 vs 1.31±0.79, respectively) and Ea / Ees remained within normal limits (0.69 ± 0.20). In patients with CHF-LEF increasing of Ea (2.18±0.98) at normal Ees (1.31±0.79) led to the most pronounced disorder of ventricular-arterial coupling (Ea/Ees =1.96±1.01). Patients with hypertension occupied an intermediate value between the two previous groups of patients: average Ea, Ees and Ea/Ees were 2.62±0.91, 4.31±1.18 and 0.63±0.91, respectively. It was concluded that patients with heart failure and low ejection fraction are characterized by higher index of arterial stiffness and peripheral vasoconstriction, as well as more significant violations of ventricular-arterial coupling than patients with CHF-PEF and patients with hypertension. Patients with CHF-PEF show higher rates of augmentation index, as well as arterial and end-systolic elasticity in comparison with patients with arterial hypertension.

Keywords:

chronic heart failure with preserved ejection fraction

effective arterial elasticity

end-systolic elasticity

ventricular-arterial coupling

Authors:

Dikur O.N.

Kafedra profilakticheskoĭ i neotlozhnoĭ kardiologii IPO Pervogo MGMU im. I.M. Sechenova

Poltavskaya M.G.

Sechenov First Moscow State Medical University, Moscow, Russia

Giverts I.Iu.

GBOU VPO "Pervyĭ MGMU im. I.M. Sechenova" Minzdrava Rossii;
kafedra profilakticheskoĭ i neotlozhnoĭ kardiologii FPPOV Pervogo MGMU im. I.M. Sechenova, klinika kardiologii

Doletskiĭ A.A.

GOU VPO Pervyĭ MGMU im. I.M. Sechenova Minzdrava Rossii

Pesheva O.V.

Kafedra profilakticheskoĭ i neotlozhnoĭ kardiologii IPO Pervogo MGMU im. I.M. Sechenova

Syrkin A.L.

Sechenov First Moscow State Medical University

Scopus AuthorID: 7103104759
ORCID: 0000-0002-9602-292X

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References:

Almeida P., Rodrigues J., Lourenço P., Maciel M.J. et al. Prognostic significance of applying the European Society of Cardiology consensus algorithm for heart failure with preserved systolic function diagnosis. Clin Cardiol 2012; 35: 12: 770-776.
Argulian E., Agarwal V., Makani H., Herzog E. et al. Association of Exercise Tolerance with Effective Arterial Elastance Obtained Noninvasively in Patients with Exertional Dyspnea. J Am Soc Echocardiogr 2014; S0894-7317(14)00100-X.
Borlaug B.A., Kass D.A. Mechanisms of diastolic dysfunction in heart failure. Trends Cardiovasc Med 2006; 16: 8: 273-279.
Borlaug B.A., Kass D.A. Ventricular-vascular interaction in heart failure. Heart Failure Clin 2008; 4: 23-36.
Borlaug B.A., Lam C.S., Roger V.L., Rodeheffer R.J. et al. Contractility and ventricular systolic stiffening in hypertensive heart disease insights into the pathogenesis of heart failure with preserved ejection fraction. J Am Coll Cardiol 2009; 54: 5: 410-418.
Borlaug B.A., Melenovsky V., Redfield M.M., Kessler K. et al. Impact of Arterial Load and Loading Sequence on Left Ventricular Tissue Velocities in Humans. J Am Coll Cardiol 2007; 50: 1570-1577.
Borlaug B.A., Nishimura R.A., Sorajja P., Lam C.S. et al. Exercise hemodynamics enhance diagnosis of early heart failure with preserved ejection fraction. Circulat Heart Fail 2010; 3: 5: 588-595.
Chantler P.D., Lakatta E.G., Najjar S.S. Arterial-ventricular coupling: mechanistic insights into cardiovascular performance at rest and during exercise. J Appl Physiol 2008; 105: 1342-1351.
Chen C.H., Fetics B., Nevo E., Rochitte S.E. et al. Kawaguchi M, Kass DA. Noninvasive Single-Beat Determination of Left Ventricular End-Systolic Elastance in Humans. J Am Coll Cardiol 2001; 38: 2028-2034.
Chirinos J.A., Kips J.G., Jacobs J.R. et al. Arterial wave reflections and incident cardiovascular events and heart failure: MESA (Multiethnic study of atherosclerosis). J Am Coll Cardiol 2012; 60: 2170-2177.
Chirinos J.A., Rietzschel E.R., De Buyzere M.L., De Bacquer D. et al. Arterial Load and Ventricular-Arterial Coupling Physiologic Relations With Body Size and Effect of Obesity. Hypertension 2009; 54: 558-566.
Claessens T.E., Rietzschel E.R., De Buyzere M.L., De Bacquer D. et al. Noninvasive assessment of left ventricular and myocardial contractility in middle-aged men and women: disparate evolution above the age of 50? Am J Physiol Heart Circulat Physiol 2007; 292: 856-865.
Dickstein K., Cohen-Solal A., Filippatos G., McMurray J.J. et al. ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2008 The Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2008 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association of the ESC (HFA) and endorsed by the European Society of Intensive Care Medicine (ESICM). Eur J Heart Fail 2008; 10: 933-989.
Fukuta H., Ohte N., Wakami K., Asada K. et al. Impact of Arterial Load on Left Ventricular Diastolic Function in Patients Undergoing Cardiac Catheterization for Coronary Artery Disease. Jpn Circulat J 2010; 74: 1900-1905.
Gillebert T.C., Leite-Moreira A.F., De Hert S.G. Load dependent diastolic dysfunction in heart failure. Heart Fail Rev 2000; 5: 4: 345-355.
Hunt S.A., Abraham W.T., Chin M.H. et al. ACC/AHA 2005 Guideline Update for the Diagnosis and Management of Chronic Heart Failure in the Adult: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Update the 2001 Guidelines for the Evaluation and Management of Heart Failure): developed in collaboration with the American College of Chest Physicians and the International Society for Heart and Lung Transplantation: endorsed by the Heart Rhythm Society. Circulation 2005; 112: e154-e235.
Kawaguchi M., Hay I., Fetics B., Kass D.A. Combined ventricular systolic and arterial stiffening in patients with heart failure and preserved ejection fraction: implications for systolic and diastolic reserve limitations. Circulation 2003; 107: 714-720.
Lam C.S., Donal E., Kraigher-Krainer E., Vasan R.S. Epidemiology and clinical course of heart failure with preserved ejection fraction. Eur J Heart Fail 2011; 13: 1: 18-28.
Lam C.S.P., Roger V.L., Rodeheffer R.J., Bursi F. et al. Cardiac Structure and Ventricular-Vascular Function in Persons With Heart Failure and Preserved Ejection Fraction From Olmsted County, Minnesota. Circulation 2007; 115: 1982-1990.
Laurent S., Cockcroft J., Van Bortel L., Boutouyrie P. et al. Expert consensus document on arterial stiffness: methodological issues and clinical applications. Eur Heart J 2006; 27: 2588-2605.
Leite-Moreira A.F., Correia-Pinto J., Gillebert T.C. Afterload induced changes in myocardial relaxation: A mechanism for diastolic dysfunction. Cardiovas Res 1999; 43: 344-353.
Leong D.P., De Pasquale C.G., Selvanayagam J.B. Heart failure with normal ejection fraction: the complementary roles of echocardiography and CMR imaging. JACC 2010; 3: 409-420.
Lloyd-Jones D., Adams R.J., Brown T.M. et al. American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Executive summary: heart disease and stroke statistics - 2010 update: a report from the American Heart Association. Circulation 2010; 121: e46-e215.
London G.M., Blacher J., Pannier B., Guerin A.P. et al. Arterial wave reflections and survival in end-stage renal failure. Hypertension 2001; 38: 434-438.
Maeder M.T., Kaye D.M. Heart Failure With Normal Left Ventricular Ejection Fraction. J Am Coll Cardiol 2009; 53: 905-918.
Ohtani T., Mohammed S.F., Yamamoto K., Dunlay S.M. et al. Diastolic stiffness as assessed by diastolic wall strain is associated with adverse remodelling and poor outcomes in heart failure with preserved ejection fraction. Eur Heart J 2012; 33: 14: 1742-1749.
Paulus W.J., Tschope C., Sanderson J.E., Rusconi C. et al. How to diagnose diastolic heart failure: a consensus statement on the diagnosis of heart failure with normal left ventricular ejection fraction by the Heart Failure and Echocardiography Associations of the European Society of Cardiology. Eur Heart J 2007; 28: 2539-2550.
Penicka M., Bartunek J., Trakalova H., Hrabakova H. et al. Heart failure with preserved ejection fraction in outpatients with unexplained dyspnea: a pressure-volume loop analysis. J Am Coll Cardiol 2010; 20:55: 16: 1701-1710.
Smiseth O.A., Michal T. Diastolic Heart Failure. London: Springer-Verlag Limited 2008; 616.
Staessen J.A., Gasowski J., Wang J.G., Thijs L. et al. Risk of untreated and treated isolated systolic hypertension in the elderly: metaanalysis of outcome trials. Lancet 2000; 355: 865-872.
Takimoto E., Soergel D.G., Janssen P.M., Stull L.B. et al. Frequency- and afterload-dependent cardiac modulation in vivo by troponin I with constitutively active protein kinase A phosphorylation sites. Circulat Res 2004; 94: 4: 496-504.
Weber T., Auer J., O'Rourke M.F., Kvas E. et al. Increased arterial wave reflections predict severe cardiovascular events in patients undergoing percutaneous coronary interventions. Eur Heart J 2005; 26: 2657-2663.
Welles C.C., Ku I.A., Kwan D.M., Whooley M.A. et al. Left atrial function predicts heart failure hospitalization in subjects with preserved ejection fraction and coronary heart disease: longitudinal data from the Heart and Soul Study. J Am Coll Cardiol 2012; 59: 7: 673-680.
Willus-Hansen T., Staessen J.A., Torp-Pedersen C., Rasmussen S. et al. Prognostic value of aortic pulse wave velocity as index of arterial stiffness in the general population. Circulation 2006; 113: 664-670.
Zile M.R., Baicu C.F., Gaasch W.H. Diastolic heart failure-abnormalities in active relaxation and passive stiffness of the left ventricle. N Engl J Med 2004; 350: 1953-1959.