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

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 2025-2 (Russian Journal of Cardiology and Cardiovascular Surgery)

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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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