Author + information
- Julio A. Chirinos,
- Prithvi Shiva-Kumar,
- Rahul Chandrashekhar,
- Philip Haines,
- Amin Vakilipour,
- Hassam Saif,
- Walter Witschey,
- Nirzari Pandya,
- Patrick Segers,
- Victor Ferrari and
- Scott Akers
Accumulating animal and human data link specific components of arterial load (such as wave reflections) with LV remodeling and incident heart failure. However, data relating arterial load assessed via proximal aortic pressure-flow analyses and LV concentric hypertrophy assessed via magnetic resonance imaging (MRI), the gold standard non-invasive method for LV mass measurements, are not available.
We studied 81 adults without significant mitral or aortic valve disease. We assessed arterial load using aortic pressure-flow modeling. Aortic flow was measured with through-plane phase-contrast MRI. Central arterial pressure waveforms were acquired using carotid arterial tonometry. LV mass and volumes were measured using steady-state free precession imaging. In order to assess concentric LV hypertrophy, we used regression models that predicted LV mass (LVM) adjusting for LV end-diastolic volume.
In age- and sex-adjusted models (Table), a greater LVM was associated with higher proximal aortic characteristic impedance (standardized beta=0.37; P=0.01) and a shorter time to reflected wave arrival at the central aorta (standardized beta=-0.29; P=0.007). These results did not appreciably change after adjustment for relevant cardiovascular risk factors or medication use.
Our results identify ascending aortic characteristic impedance and early wave reflections as the key arterial hemodynamic correlates of concentric LV hypertrophy in adults.
|Model R2=0.39||Standardized Beta||P value|
|Ascending Aortic Characteristic Impedance||0.374||0.01|
|Total Arterial Compliance||0.167||0.25|
|Total peripheral resistance||−0.063||0.58|
|Reflected wave transit time||−0.287||0.007|
|LV end-diastolic volume||0.42||<0.0001|
Poster Sessions, Expo North
Monday, March 11, 2013, 9:45 a.m.-10:30 a.m.
Session Title: Preclinical Manifestations of Hypertension and Arterial Stiffness
Abstract Category: 25. Prevention: Hypertension
Presentation Number: 1276-24
- 2013 American College of Cardiology Foundation