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Resistive and pulsatile arterial load as predictors of left ventricular mass and geometry: the multi-ethnic study of atherosclerosis

(2015) HYPERTENSION. 65(1). p.85-92
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Abstract
Arterial load is composed of resistive and various pulsatile components, but their relative contributions to left ventricular (LV) remodeling in the general population are unknown. We studied 4145 participants enrolled in the Multi-Ethnic Study of Atherosclerosis, who underwent cardiac MRI and radial arterial tonometry. We computed systemic vascular resistance (SVR=mean arterial pressure/cardiac output) and indices of pulsatile load including total arterial compliance (TAC, approximated as stroke volume/central pulse pressure), forward wave amplitude (P-f), and reflected wave amplitude (P-b). TAC and SVR were adjusted for body surface area to allow for appropriate sex comparisons. We performed allometric adjustment of LV mass for body size and sex and computed standardized regression coefficients (beta) for each measure of arterial load. In multivariable regression models that adjusted for multiple confounders, SVR (beta=0.08; P<0.001), TAC (beta=0.44; P<0.001), P-b (beta=0.73; P<0.001), and P-f (beta=-0.23; P=0.001) were significant independent predictors of LV mass. Conversely, TAC (beta=-0.43; P<0.001), SVR (beta=0.22; P<0.001), and P-f (beta=-0.18; P=0.004) were independently associated with the LV wall/LV cavity volume ratio. Women demonstrated greater pulsatile load than men, as evidenced by a lower indexed TAC (0.89 versus 1.04 mL/mm Hg per square meter; P<0.0001), whereas men demonstrated a higher indexed SVR (34.0 versus 32.8 Wood Unitsxm2; P<0.0001). In conclusion, various components of arterial load differentially associate with LV hypertrophy and concentric remodeling. Women demonstrated greater pulsatile load than men. For both LV mass and the LV wall/LV cavity volume ratio, the loading sequence (ie, early load versus late load) is an important determinant of LV response to arterial load.
Keywords
left ventricular, hypertrophy, vascular resistance, ventricular remodeling, PRESERVED EJECTION FRACTION, PRESSURE WAVE-FORM, CARDIOVASCULAR RISK-FACTORS, SEX-DIFFERENCES, HEART-FAILURE, DIASTOLIC FUNCTION, NONINVASIVE EVALUATION, UPPER-LIMB, BODY-SIZE, REFLECTION

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Chicago
Zamani, Payman, David A Bluemke, David R Jacobs Jr, Daniel Duprez, Richard Kronmal, Scott M Lilly, Victor A Ferrari, et al. 2015. “Resistive and Pulsatile Arterial Load as Predictors of Left Ventricular Mass and Geometry: The Multi-ethnic Study of Atherosclerosis.” Hypertension 65 (1): 85–92.
APA
Zamani, P., Bluemke, D. A., Jacobs, D. R., Jr, Duprez, D., Kronmal, R., Lilly, S. M., Ferrari, V. A., et al. (2015). Resistive and pulsatile arterial load as predictors of left ventricular mass and geometry: the multi-ethnic study of atherosclerosis. HYPERTENSION, 65(1), 85–92.
Vancouver
1.
Zamani P, Bluemke DA, Jacobs DR Jr, Duprez D, Kronmal R, Lilly SM, et al. Resistive and pulsatile arterial load as predictors of left ventricular mass and geometry: the multi-ethnic study of atherosclerosis. HYPERTENSION. 2015;65(1):85–92.
MLA
Zamani, Payman, David A Bluemke, David R Jacobs Jr, et al. “Resistive and Pulsatile Arterial Load as Predictors of Left Ventricular Mass and Geometry: The Multi-ethnic Study of Atherosclerosis.” HYPERTENSION 65.1 (2015): 85–92. Print.
@article{5800845,
  abstract     = {Arterial load is composed of resistive and various pulsatile components, but their relative contributions to left ventricular (LV) remodeling in the general population are unknown. We studied 4145 participants enrolled in the Multi-Ethnic Study of Atherosclerosis, who underwent cardiac MRI and radial arterial tonometry. We computed systemic vascular resistance (SVR=mean arterial pressure/cardiac output) and indices of pulsatile load including total arterial compliance (TAC, approximated as stroke volume/central pulse pressure), forward wave amplitude (P-f), and reflected wave amplitude (P-b). TAC and SVR were adjusted for body surface area to allow for appropriate sex comparisons. We performed allometric adjustment of LV mass for body size and sex and computed standardized regression coefficients (beta) for each measure of arterial load. In multivariable regression models that adjusted for multiple confounders, SVR (beta=0.08; P{\textlangle}0.001), TAC (beta=0.44; P{\textlangle}0.001), P-b (beta=0.73; P{\textlangle}0.001), and P-f (beta=-0.23; P=0.001) were significant independent predictors of LV mass. Conversely, TAC (beta=-0.43; P{\textlangle}0.001), SVR (beta=0.22; P{\textlangle}0.001), and P-f (beta=-0.18; P=0.004) were independently associated with the LV wall/LV cavity volume ratio. Women demonstrated greater pulsatile load than men, as evidenced by a lower indexed TAC (0.89 versus 1.04 mL/mm Hg per square meter; P{\textlangle}0.0001), whereas men demonstrated a higher indexed SVR (34.0 versus 32.8 Wood Unitsxm2; P{\textlangle}0.0001). In conclusion, various components of arterial load differentially associate with LV hypertrophy and concentric remodeling. Women demonstrated greater pulsatile load than men. For both LV mass and the LV wall/LV cavity volume ratio, the loading sequence (ie, early load versus late load) is an important determinant of LV response to arterial load.},
  author       = {Zamani, Payman and Bluemke, David A and Jacobs, David R, Jr and Duprez, Daniel and Kronmal, Richard and Lilly, Scott M and Ferrari, Victor A and Townsend, Raymond R and Lima, Joao A and Budoff, Matthew and Segers, Patrick and Hannan, Peter and Chirinos Medina, Julio},
  issn         = {0194-911X},
  journal      = {HYPERTENSION},
  keyword      = {left ventricular,hypertrophy,vascular resistance,ventricular remodeling,PRESERVED EJECTION FRACTION,PRESSURE WAVE-FORM,CARDIOVASCULAR RISK-FACTORS,SEX-DIFFERENCES,HEART-FAILURE,DIASTOLIC FUNCTION,NONINVASIVE EVALUATION,UPPER-LIMB,BODY-SIZE,REFLECTION},
  language     = {eng},
  number       = {1},
  pages        = {85--92},
  title        = {Resistive and pulsatile arterial load as predictors of left ventricular mass and geometry: the multi-ethnic study of atherosclerosis},
  url          = {http://dx.doi.org/10.1161/HYPERTENSIONAHA.114.04333},
  volume       = {65},
  year         = {2015},
}

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