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Arterial Stiffness, Central Blood Pressure and Cardiac Remodelling: From Cardiac Hypertrophy to Heart Failure

  • Mary J. RomanEmail author
  • Richard B. Devereux
Chapter

Abstract

Over the past several decades much has been learned about arterial stiffness and central blood pressure (BP) and their relations to left ventricular (LV) remodelling and hypertrophy. In addition, the impact of central hemodynamics on LV performance and the development of clinical heart failure is under active investigation and is of particular importance from a public health and therapeutic standpoint. The ability to examine these topics has been vastly accelerated by the development of reliable, noninvasive technology to permit evaluation of cardiac and vascular structure and function on an epidemiologic scale. The present review will discuss data regarding the interaction of arterial stiffness and central BP with LV structure and function; the impact of arterial stiffness on the development of heart failure, particularly with preserved ejection fraction, will also be discussed.

Keywords

Arterial stiffness Central blood pressure Left ventricular hypertrophy Heart failure 

Abbreviations

AUC

Area under the curve

BP

Blood pressure

HFPEF

Heart failure with preserved ejection fraction

LV

Left ventricular

LVETi

Left ventricular ejection time index

NT-proBNP

N-terminal pro-B-type natriuretic peptides

PP

Pulse pressure

ROC

Receiver operating characteristic

References

  1. 1.
    Karamanoglu M, O’Rourke MF, Avolio AP, Kelly RP. An analysis of the relationship between central aortic and peripheral upper limb pressure waves in man. Eur Heart J. 1993;14:160–7.PubMedCrossRefGoogle Scholar
  2. 2.
    Westerhof BE, Guelen I, Stok WJ, Lasance HAJ, Ascoop CAPL, Wesseling KH, Westerhof N, Bos WJW, Stergiopulos N, Spaan JAE. Individualization of transfer function in estimation of central aortic pressure from the peripheral pulse is not required in patients at rest. J Appl Physiol. 2008;105:1858–63.PubMedCrossRefGoogle Scholar
  3. 3.
    Sharman JE, Lim R, Qasem AM, Coombes JS, Burgess MI, Franco J, Garrahy P, Wilkinson IB, Marwick TH. Validation of a generalized transfer function to noninvasively derived central blood pressure during exercise. Hypertension. 2006;47:1203–8.PubMedCrossRefGoogle Scholar
  4. 4.
    Devereux RB, Reichek N. Echocardiographic determination of left ventricular mass in man. Anatomic validation of the method. Circulation. 1977;55:613–8.PubMedCrossRefGoogle Scholar
  5. 5.
    Lang RM, Bierig M, Devereux RB, Flachskampf FA, Foster E, Pellikka PA, Picard MH, Roman MJ, Seward J, Shanewise JS, Solomon SD, Spencer KT, St John Sutton M, Stewart WJ. Recommendations for chamber quantification: a report from the American Society of Echocardiography’s Guidelines and Standards Committee and the Chamber Quantification Writing Group, developed in conjunction with the European Association of Echocardiography, a branch of the European Society of Cardiology. J Am Soc Echocardiogr. 2005;18:1440–63.PubMedCrossRefGoogle Scholar
  6. 6.
    de Simone G, Daniels SR, Devereux RB, et al. Left ventricular mass and body size in normotensive children and adults: assessment of allometric relations and of the impact of overweight. J Am Coll Cardiol. 1992;20:1251–60.PubMedCrossRefGoogle Scholar
  7. 7.
    Ganau A, Devereux RB, Roman MJ, et al. Patterns of left ventricular hypertrophy and geometric remodelling in essential hypertension. J Am Coll Cardiol. 1992;19:1550–8.PubMedCrossRefGoogle Scholar
  8. 8.
    Khouri MG, Peshock RM, Ayers CR, de Lemos JA, Drazner MH. A 4-tiered classification of left ventricular hypertrophy based on left ventricular geometry: the Dallas Heart Study. Circ Cardiovasc Imaging. 2010;3:164–71.PubMedCrossRefGoogle Scholar
  9. 9.
    Bang CN, Gerdts E, Aurigemma GP, Boman K, Dahlof B, Roman MJ, Kober L, Wachtell K, Devereux RB. Systolic left ventricular function according to left ventricular concentricity and dilatation in hypertensive patients: the Losartan Intervention For Endpoint reduction in hypertension study. J Hypertens. 2013;31:2060–8.PubMedCrossRefGoogle Scholar
  10. 10.
    Bella JN, Devereux RB, Roman MJ, et al. Relations of left ventricular mass to fat-free and adipose body mass: the Strong Heart Study. Circulation. 1998;98:2538–44.PubMedCrossRefGoogle Scholar
  11. 11.
    Kuch B, Hense H-W, Gneiting B, et al. Body composition and prevalence of left ventricular hypertrophy. Circulation. 2000;102:405–10.PubMedCrossRefGoogle Scholar
  12. 12.
    Chen C-H, Ting C-T, Lin S-J, His T-L, Ho S-J, Chou P, et al. Which arterial and cardiac parameters best predict left ventricular mass? Circulation. 1998;98:422–8.PubMedCrossRefGoogle Scholar
  13. 13.
    Flack JM, Gardin JM, Yunis C, Liu K, for the CARDIA Research Group. Static and pulsatile blood pressure correlates of left ventricular structure and function in black and white young adults: the CARDIA Study. Am Heart J. 1999;138:856–64.Google Scholar
  14. 14.
    Verdecchia P, Schillaci G, Borgioni C, Gaatobigio R, Ambrosio G, Porcellati C. Prevalent influence of systolic over pulse pressure on left ventricular mass in essential hypertension. Eur Heart J. 2002;23:658–65.PubMedCrossRefGoogle Scholar
  15. 15.
    Roman MJ, Okin PM, Kizer JR, Lee ET, Howard BV, Devereux RB. Relations of central and brachial blood pressure to left ventricular hypertrophy and geometry: the Strong Heart Study. J Hypertens. 2010;28:384–8.PubMedCrossRefGoogle Scholar
  16. 16.
    Wang K-L, Cheng H-M, Chuang S-Y, Spurgeon HA, Ting C-T, Lakatta EG, et al. Central or peripheral systolic or pulse pressure: which best relates to target organs and future mortality? J Hypertens. 2009;27:461–7.PubMedCentralPubMedCrossRefGoogle Scholar
  17. 17.
    Norton GR, Majane OHI, Maseko MJ, Libhaber C, Redelinghuys M, Kruger D, Veller M, Sareli P, Woodiwiss AJ. Brachial blood pressure-independent relations between radial late systolic shoulder-derived aortic pressures and target organ changes. Hypertension. 2012;59:885–92.PubMedCrossRefGoogle Scholar
  18. 18.
    Laurent S, Cockcroft J, Van Bortel L, Boutouyrie P, Giannattasio C, Hayoz D, Pannier B, Vlachopoulos C, Wilkinson I, Struijker-Boudier H, on behalf of the European Network for Non-invasive Investigation of Large Arteries. Expert consensus document on arterial stiffness: methodological issues and clinical applications. Eur Heart J. 2006;27:2588–605.Google Scholar
  19. 19.
    Roman MJ, Ganau A, Saba PS, et al. Impact of arterial stiffening on left ventricular structure. Hypertension. 2000;36:489–94.PubMedCrossRefGoogle Scholar
  20. 20.
    Roman MJ, Pickering TG, Schwartz JE, et al. Relation of arterial structure and function to left ventricular geometric patterns in hypertensive adults. J Am Coll Cardiol. 1996;28:751–6.PubMedCrossRefGoogle Scholar
  21. 21.
    Saba PS, Ganau A, Devereux RB, et al. Impact of arterial elastance as a measure of vascular load on left ventricular geometry in hypertension. J Hypertens. 1999;17:1007–15.PubMedCrossRefGoogle Scholar
  22. 22.
    Schillaci G, Mannarino MR, Pucci G, Pirro M, Helou J, Savarese G, Vaudo G, Mannarino E. Age-specific relationship of aortic pulse wave velocity with left ventricular geometry and function in hypertension. Hypertension. 2007;49:317–21.PubMedCrossRefGoogle Scholar
  23. 23.
    Ganau A, Devereux RB, Pickering TG, Roman MJ, Schnall PL, Santucci S, Spitzer MC, Laragh JH. Relation of left ventricular hemodynamic load and contractile performance to left ventricular mass in hypertension. Circulation. 1990;81:25–36.PubMedCrossRefGoogle Scholar
  24. 24.
    Chen C-H, Nakayama M, Nevo E, Fetics BJ, Maughan WL, Kass DA. Coupled systolic-ventricular and vascular stiffening with age: implications for pressure regulation and cardiac reserve in the elderly. J Am Coll Cardiol. 1998;32:1221–7.PubMedCrossRefGoogle Scholar
  25. 25.
    Lartaud-Idjouadiene I, Lompré A-M, Kieffer P, Colas T, Atkinson J. Cardiac consequences of prolonged exposure to an isolated increase in aortic stiffness. Hypertension. 1999;34:63–9.PubMedCrossRefGoogle Scholar
  26. 26.
    Redfield MM, Jacobsen SJ, Borlaug BA, Rodeheffer RJ, Kass DA. Age- and gender-related ventricular-vascular stiffening: a community-based study. Circulation. 2005;112:2254–62.PubMedCrossRefGoogle Scholar
  27. 27.
    Abhayaratna WP, Barnes ME, O’Rourke MF, Gersh BJ, Seward JB, Miyasaka Y, Bailey KR, Tsang TSM. Relation of arterial stiffness to left ventricular diastolic function and cardiovascular risk prediction in patients ≥65 years of age. Am J Cardiol. 2006;98:1387–92.PubMedCrossRefGoogle Scholar
  28. 28.
    Weber T, O’Rourke MF, Ammer M, Kvas E, Punzengruber C, Eber B. Arterial stiffness and arterial wave reflections are associated with systolic and diastolic function in patients with normal ejection fraction. Am J Hypertens. 2008;21:1194–202.PubMedCrossRefGoogle Scholar
  29. 29.
    Russo C, Jin Z, Palmieri V, Homma S, Rundek T, Elkind MSV, Sacco RL, Di Tullio MR. Arterial stiffness and wave reflection: sex differences and relationship with left ventricular diastolic function. Hypertension. 2012;60:362–8.PubMedCentralPubMedCrossRefGoogle Scholar
  30. 30.
    Fernandes VRS, Polak JF, Cheng S, Rosen BD, Carvalho B, Nasir K, McClelland R, Hundley G, Pearson G, O’Leary DH, Bluemke DA, Lima JAC. Arterial stiffness is associated with regional ventricular systolic and diastolic dysfunction: The Multi-Ethnic Study of Atherosclerosis. Arterioscler Thromb Vasc Biol. 2008;28:194–201.PubMedCrossRefGoogle Scholar
  31. 31.
    Borlaug BA, Paulus WJ. Heart failure with preserved ejection fraction: pathophysiology, diagnosis and treatment. Eur Heart J. 2011;32:670–9.PubMedCentralPubMedCrossRefGoogle Scholar
  32. 32.
    Haider AW, Larson MG, Franklin SS, Levy D. Systolic blood pressure, diastolic blood pressure and pulse pressure as predictors of risk for congestive heart failure in the Framingham Heart Study. Ann Intern Med. 2003;138:10–6.PubMedCrossRefGoogle Scholar
  33. 33.
    Chae CU, Pfeffer MA, Glynn RJ, Mitchell GF, Taylor JO, Hennekens CH. Increased pulse pressure and risk of heart failure in the elderly. JAMA. 1999;281:634–9.PubMedCrossRefGoogle Scholar
  34. 34.
    Vaccarino V, Holfrod TR, Krumholz HM. Pulse pressure and risk of myocardial infarction and heart failure in the elderly. J Am Coll Cardiol. 2000;36:130–8.PubMedCrossRefGoogle Scholar
  35. 35.
    Kostis JB, Lawrence-Nelson J, Ranjan R, Wilson AC, Kostis WJ, Lacy CR. Association of increased pulse pressure with the development of heart failure in SHEP. Am J Hypertens. 2001;14:798–803.PubMedCrossRefGoogle Scholar
  36. 36.
    Domanski MJ, Mitchell GF, Normal JE, Exner DV, Pitt B, Pfeffer MA. Independent prognostic information provided by sphygmomanometrically determined pulse pressure and mean arterial pressure in patients with left ventricular dysfunction. J Am Coll Cardiol. 1999;33:951–8.PubMedCrossRefGoogle Scholar
  37. 37.
    Tartière J-M, Logaert D, Safar M, Cohen-Solal A. Interaction between pulse wave velocity, augmentation index, pulse pressure and left ventricular function in chronic heart failure. J Hum Hypertens. 2006;20:213–9.PubMedCrossRefGoogle Scholar
  38. 38.
    Kawaguchi M, Hay I, Fetics B, Kass DA. Combined ventricular systolic and arterial stiffening in patients with heart failure and preserved ejection fraction: implications for systolic and diastolic reserve limitations. Circulation. 2003;107:714–20.PubMedCrossRefGoogle Scholar
  39. 39.
    Lam CSP, Roger VL, Rodeheffer RJ, Bursi F, Borlaug BA, Ommen SR, Kass DA, Redfield MM. Cardiac structure and ventricular-vascular function in persons with heart failure and preserved ejection fraction from Olmsted County, Minnesota. Circulation. 2007;115:1982–90.PubMedCentralPubMedCrossRefGoogle Scholar
  40. 40.
    Weber T, Auer J, O’Rourke MF, Punzengruber C, Kvas E, Eber B. Prolonged mechanical systole and increased arterial wave reflections in diastolic dysfunction. Heart. 2006;92:1616–22.PubMedCentralPubMedCrossRefGoogle Scholar
  41. 41.
    Weber T, Wassertheurer S, O’Rourke MF, Haiden A, Zweiker R, Rammer M, Hametner B, Eber B. Pulsatile hemodynamics in patients with exertional dyspnea: potentially of value in the diagnostic evaluation of suspected heart failure with preserved ejection fraction. J Am Coll Cardiol. 2013;61:1874–83.PubMedCrossRefGoogle Scholar
  42. 42.
    Tartière-Kesri L, Tartière J-M, Logeart D, Beauvais F, Cohen SA. Increased proximal arterial stiffness and cardiac response with moderate exercise in patients with heart failure and preserved ejection fraction. J Am Coll Cardiol. 2012;59:455–61.PubMedCrossRefGoogle Scholar
  43. 43.
    Holland DJ, Sacre JW, Leano RL, Marwick TH, Sharman JE. Contribution of abnormal central blood pressure to left ventricular filling pressure during exercise in patients with heart failure and preserved ejection fraction. J Hypertens. 2011;29:1422–30.PubMedCrossRefGoogle Scholar
  44. 44.
    Hundley WG, Kitzman DW, Morgan TM, Hamilton CA, Darty SN, Stewart KP, Herrington DM, Link KM, Little WC. Cardiac cycle-dependent changes in aortic area and distensibility are reduced in older patients with isolated diastolic heart failure and correlate with exercise intolerance. J Am Coll Cardiol. 2001;38:796–802.PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag London 2014

Authors and Affiliations

  1. 1.Greenberg Division of CardiologyNew York Presbyterian Hospital, Weill Cornell Medical CollegeNew YorkUSA

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