Arterial Wave Reflections and Ventricular-Vascular Interaction in Patients With Left Ventricular Systolic Dysfunction

  • Paglia Antonella
    Department of Translational Medical Sciences- Section of Internal Medicine, University of Naples Federico II
  • Pirozzi Flora
    Department of Translational Medical Sciences- Section of Internal Medicine, University of Naples Federico II
  • Carlomagno Angelo
    Department of Translational Medical Sciences- Section of Internal Medicine, University of Naples Federico II
  • Abete Pasquale
    Department of Translational Medical Sciences- Section of Internal Medicine, University of Naples Federico II
  • Petretta Mario
    Department of Translational Medical Sciences- Section of Internal Medicine, University of Naples Federico II
  • Bonaduce Domenico
    Department of Translational Medical Sciences- Section of Internal Medicine, University of Naples Federico II
  • Sasso Laura
    Department of Translational Medical Sciences- Section of Internal Medicine, University of Naples Federico II
  • Iannuzzi Angela
    Department of Translational Medical Sciences- Section of Internal Medicine, University of Naples Federico II

書誌事項

公開日
2014
資源種別
journal article
DOI
  • 10.1536/ihj.14-159
公開者
一般社団法人 インターナショナル・ハート・ジャーナル刊行会

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説明

Central aortic pressure waveform (AoPW) is the summation of a forward–traveling wave generated by the left ventricle and a backward-traveling wave caused by the reflection of the forward wave. The aim of this study was to evaluate the effect of ventricular-vascular coupling on the morphology of AoPW in chronic heart failure patients with different degrees of left ventricular systolic dysfunction (LVSD) using pulse wave analysis (PWA). PWA of AoPW and left ventricular (LV) function were evaluated by applanation tonometry in 26 control subjects, in 12 patients with left ventricular ejection fraction (LVEF) ≤ 30%, and in 14 patients with LVEF > 30%. Augmentation pressure, augmentation index, wasted energy, and ejection duration were lower in patients with LVEF ≤ 30% than in those with LVEF > 30% and in control subjects. Furthermore, augmentation index showed an inverse correlation with Doppler mitral E-wave amplitude (r = -0.40; P = 0.04) and E/A ratio (r = -0.42; P = 0.03) and a direct correlation with deceleration time of mitral E-waves (r = 0.39; P = 0.04). In patients with severe LVSD (LVEF ≤ 30%), aortic wave reflections negatively interfere with LV function and induce a shortening of ejection duration. In contrast, AoPW is similar in patients with moderate LVSD (LVEF > 30%) and in control subjects.

収録刊行物

  • International Heart Journal

    International Heart Journal 55 (6), 526-532, 2014

    一般社団法人 インターナショナル・ハート・ジャーナル刊行会

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