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Arterial properties as determinants of time-varying myocardial stress in humans

Julio Chirinos Medina UGent, Patrick Segers UGent, Thierry Gillebert UGent, Amit Gupta, Marc De Buyzere, Dirk De Bacquer UGent, Martin St John-Sutton and Ernst Rietzschel UGent (2012) HYPERTENSION. 60(1). p.64-70
abstract
Myocardial and arterial load are time-varying phenomena. Despite their importance in myocardial function, the arterial properties that determine time-resolved myocardial wall stress are unknown. We aimed to assess arterial properties as determinants of time-resolved myocardial stress among 1,214 men and women enrolled in the Asklepios study. Time-resolved central pressure, flow and left ventricular (LV) geometry were measured with carotid tonometry, Doppler and speckle-tracking echocardiography, respectively, for computation of arterial load and ejection-phase time-varying myocardial wall stress. For any given end-diastolic LV geometry and cardiac output, peak myocardial stress correlated directly with systemic vascular resistance (SVR; Standardized β=1.12; P<0.0001) and aortic characteristic impedance (Std β=0.17; P<0.0001). The ejection-phase stress-time integral correlated with SVR (Std β=1.06; P<0.0001), lower total arterial compliance (Std β=-0.13; P=0.0008) and earlier return of wave reflections (Std β=-0.10; P<0.0001) but not with reflection magnitude, whereas end-systolic wall stress correlated with SVR (Std β=1.06; P<0.0001) and reflection magnitude (Std β=0.12; P<0.0001). After adjustment for age, all measured arterial properties, end-diastolic LV geometry and cardiac output, women demonstrated greater peak (534 vs. 507 kdynes/cm2; P<0.0001), end-systolic (335 vs. 320 kdynes/cm2; P<0.0001) and ejection-phase stress-time integral (157 vs. 142 kdyne•s•cm-2; P<0.0001). In conclusion, different arterial properties have selective effects on time-resolved ejection-phase myocardial wall stress, which are not apparent from single-time point measurements. Women demonstrate less efficient myocardial-arterial coupling, with higher wall stress development for any given LV geometry, arterial properties and flow output. These observations may relate to the differential susceptibility of women to heart failure.
Please use this url to cite or link to this publication:
author
organization
year
type
journalArticle (original)
publication status
published
subject
keyword
afterload, arterial load, wave reflections, sex differences, myocardial stress, LEFT-VENTRICULAR HYPERTROPHY, SYSTOLIC PRESSURE, WAVE REFLECTION, HEART-FAILURE, IMPEDANCE, VOLUME
journal title
HYPERTENSION
Hypertension
volume
60
issue
1
pages
64 - 70
Web of Science type
Article
Web of Science id
000305574200022
JCR category
PERIPHERAL VASCULAR DISEASE
JCR impact factor
6.873 (2012)
JCR rank
3/66 (2012)
JCR quartile
1 (2012)
ISSN
0194-911X
DOI
10.1161/HYPERTENSIONAHA.112.190710
project
Asklepios study
language
English
UGent publication?
yes
classification
A1
copyright statement
I have transferred the copyright for this publication to the publisher
id
2132838
handle
http://hdl.handle.net/1854/LU-2132838
date created
2012-06-05 13:52:50
date last changed
2016-12-19 15:42:54
@article{2132838,
  abstract     = {Myocardial and arterial load are time-varying phenomena. Despite their importance in myocardial function, the arterial properties that determine time-resolved myocardial wall stress are unknown. We aimed to assess arterial properties as determinants of time-resolved myocardial stress among 1,214 men and women enrolled in the Asklepios study. Time-resolved central pressure, flow and left ventricular (LV) geometry were measured with carotid tonometry, Doppler and speckle-tracking echocardiography, respectively, for computation of arterial load and ejection-phase time-varying myocardial wall stress. For any given end-diastolic LV geometry and cardiac output, peak myocardial stress correlated directly with systemic vascular resistance (SVR; Standardized \ensuremath{\beta}=1.12; P{\textlangle}0.0001) and aortic characteristic impedance (Std \ensuremath{\beta}=0.17; P{\textlangle}0.0001). The ejection-phase stress-time integral correlated with SVR (Std \ensuremath{\beta}=1.06; P{\textlangle}0.0001), lower total arterial compliance (Std \ensuremath{\beta}=-0.13; P=0.0008) and earlier return of wave reflections (Std \ensuremath{\beta}=-0.10; P{\textlangle}0.0001) but not with reflection magnitude, whereas end-systolic wall stress correlated with SVR (Std \ensuremath{\beta}=1.06; P{\textlangle}0.0001) and reflection magnitude (Std \ensuremath{\beta}=0.12; P{\textlangle}0.0001). After adjustment for age, all measured arterial properties, end-diastolic LV geometry and cardiac output, women demonstrated greater peak (534 vs. 507 kdynes/cm2; P{\textlangle}0.0001), end-systolic (335 vs. 320 kdynes/cm2; P{\textlangle}0.0001) and ejection-phase stress-time integral (157 vs. 142 kdyne{\textbullet}s{\textbullet}cm-2; P{\textlangle}0.0001). In conclusion, different arterial properties have selective effects on time-resolved ejection-phase myocardial wall stress, which are not apparent from single-time point measurements. Women demonstrate less efficient myocardial-arterial coupling, with higher wall stress development for any given LV geometry, arterial properties and flow output. These observations may relate to the differential susceptibility of women to heart failure.},
  author       = {Chirinos Medina, Julio and Segers, Patrick and Gillebert, Thierry and Gupta, Amit and De Buyzere, Marc and De Bacquer, Dirk and St John-Sutton, Martin and Rietzschel, Ernst},
  issn         = {0194-911X},
  journal      = {HYPERTENSION},
  keyword      = {afterload,arterial load,wave reflections,sex differences,myocardial stress,LEFT-VENTRICULAR HYPERTROPHY,SYSTOLIC PRESSURE,WAVE REFLECTION,HEART-FAILURE,IMPEDANCE,VOLUME},
  language     = {eng},
  number       = {1},
  pages        = {64--70},
  title        = {Arterial properties as determinants of time-varying myocardial stress in humans},
  url          = {http://dx.doi.org/10.1161/HYPERTENSIONAHA.112.190710},
  volume       = {60},
  year         = {2012},
}

Chicago
Chirinos Medina, Julio, Patrick Segers, Thierry Gillebert, Amit Gupta, MARC DE BUYZERE, Dirk De Bacquer, Martin St John-Sutton, and Ernst Rietzschel. 2012. “Arterial Properties as Determinants of Time-varying Myocardial Stress in Humans.” Hypertension 60 (1): 64–70.
APA
Chirinos Medina, J., Segers, P., Gillebert, T., Gupta, A., DE BUYZERE, M., De Bacquer, D., St John-Sutton, M., et al. (2012). Arterial properties as determinants of time-varying myocardial stress in humans. HYPERTENSION, 60(1), 64–70.
Vancouver
1.
Chirinos Medina J, Segers P, Gillebert T, Gupta A, DE BUYZERE M, De Bacquer D, et al. Arterial properties as determinants of time-varying myocardial stress in humans. HYPERTENSION. 2012;60(1):64–70.
MLA
Chirinos Medina, Julio, Patrick Segers, Thierry Gillebert, et al. “Arterial Properties as Determinants of Time-varying Myocardial Stress in Humans.” HYPERTENSION 60.1 (2012): 64–70. Print.