Ventricular-arterial coupling in centenarians without cardiovascular diseases

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3 Citations (Scopus)

Abstract

Background: Ventricular-arterial (VA) coupling is a central determinant of cardiovascular system performance and cardiac energetics. This index is expressed by the Ea/Ees ratio, where the effective arterial elastance (Ea) indicates the net arterial load exerted on the left ventricle and the left ventricular end-systolic elastance (Ees) is a load-independent measure of left ventricular chamber performance. Methods: Thirty-three centenarians (100.6 ± 1.2 years, range 99–105 years, 10 M) without cardiovascular diseases underwent a complete echocardiographic evaluation and an instantaneous arterial blood pressure measurement, to characterize the Ea/Ees ratio and its two determinants indexed to body surface area. Results: VA coupling was markedly reduced (Ea/Ees ratio 0.40 ± 0.1), reflecting a disproportionate increase in Ees index (8.5 ± 2.2 mmHg/ml/m2) compared with Ea index (3.2 ± 0.8 mmHg/ml/m2). Notably, the coupling ratio was significantly lower in women (0.37 ± 0.1) than in men (0.45 ± 0.1, p = 0.0003), due to an increase in Ees index significantly greater in women (9.4 ± 1.9 mmHg/ml/m2) than in men (6.5 ± 1.5 mmHg/ml/m2, p = 0.0002). Using multivariate regression analysis, only female gender (β coefficient −0.04, p = 0.01) and relative wall thickness (β coefficient −0.49, p < 0.0001) showed a significant inverse correlation to VA coupling. Conclusions: Our analysis in a population of centenarians without overt cardiovascular disease revealed very low values of VA coupling, especially in women. Both a LV structural remodeling as well as a high aortic elastance might have contributed to a secondary disproportionate increase in myocardial stiffness.

Original languageEnglish
Pages (from-to)1-7
Number of pages7
JournalAging clinical and experimental research
DOIs
Publication statusAccepted/In press - Jun 14 2017

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Cardiovascular Diseases
Body Surface Area
Cardiovascular System
Heart Ventricles
Arterial Pressure
Multivariate Analysis
Regression Analysis
Population

Keywords

  • Centenarians
  • Echocardiographic evaluation
  • Ventricular-arterial coupling

ASJC Scopus subject areas

  • Ageing
  • Geriatrics and Gerontology

Cite this

@article{771aaa99c5524f639044f5911852b918,
title = "Ventricular-arterial coupling in centenarians without cardiovascular diseases",
abstract = "Background: Ventricular-arterial (VA) coupling is a central determinant of cardiovascular system performance and cardiac energetics. This index is expressed by the Ea/Ees ratio, where the effective arterial elastance (Ea) indicates the net arterial load exerted on the left ventricle and the left ventricular end-systolic elastance (Ees) is a load-independent measure of left ventricular chamber performance. Methods: Thirty-three centenarians (100.6 ± 1.2 years, range 99–105 years, 10 M) without cardiovascular diseases underwent a complete echocardiographic evaluation and an instantaneous arterial blood pressure measurement, to characterize the Ea/Ees ratio and its two determinants indexed to body surface area. Results: VA coupling was markedly reduced (Ea/Ees ratio 0.40 ± 0.1), reflecting a disproportionate increase in Ees index (8.5 ± 2.2 mmHg/ml/m2) compared with Ea index (3.2 ± 0.8 mmHg/ml/m2). Notably, the coupling ratio was significantly lower in women (0.37 ± 0.1) than in men (0.45 ± 0.1, p = 0.0003), due to an increase in Ees index significantly greater in women (9.4 ± 1.9 mmHg/ml/m2) than in men (6.5 ± 1.5 mmHg/ml/m2, p = 0.0002). Using multivariate regression analysis, only female gender (β coefficient −0.04, p = 0.01) and relative wall thickness (β coefficient −0.49, p < 0.0001) showed a significant inverse correlation to VA coupling. Conclusions: Our analysis in a population of centenarians without overt cardiovascular disease revealed very low values of VA coupling, especially in women. Both a LV structural remodeling as well as a high aortic elastance might have contributed to a secondary disproportionate increase in myocardial stiffness.",
keywords = "Centenarians, Echocardiographic evaluation, Ventricular-arterial coupling",
author = "Andrea Sonaglioni and Massimo Baravelli and Michele Lombardo and Carmen Sommese and Claudio Anz{\`a} and Kirk, {Jonathan A.} and Luigi Padeletti",
year = "2017",
month = "6",
day = "14",
doi = "10.1007/s40520-017-0783-y",
language = "English",
pages = "1--7",
journal = "Aging clinical and experimental research",
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T1 - Ventricular-arterial coupling in centenarians without cardiovascular diseases

AU - Sonaglioni, Andrea

AU - Baravelli, Massimo

AU - Lombardo, Michele

AU - Sommese, Carmen

AU - Anzà, Claudio

AU - Kirk, Jonathan A.

AU - Padeletti, Luigi

PY - 2017/6/14

Y1 - 2017/6/14

N2 - Background: Ventricular-arterial (VA) coupling is a central determinant of cardiovascular system performance and cardiac energetics. This index is expressed by the Ea/Ees ratio, where the effective arterial elastance (Ea) indicates the net arterial load exerted on the left ventricle and the left ventricular end-systolic elastance (Ees) is a load-independent measure of left ventricular chamber performance. Methods: Thirty-three centenarians (100.6 ± 1.2 years, range 99–105 years, 10 M) without cardiovascular diseases underwent a complete echocardiographic evaluation and an instantaneous arterial blood pressure measurement, to characterize the Ea/Ees ratio and its two determinants indexed to body surface area. Results: VA coupling was markedly reduced (Ea/Ees ratio 0.40 ± 0.1), reflecting a disproportionate increase in Ees index (8.5 ± 2.2 mmHg/ml/m2) compared with Ea index (3.2 ± 0.8 mmHg/ml/m2). Notably, the coupling ratio was significantly lower in women (0.37 ± 0.1) than in men (0.45 ± 0.1, p = 0.0003), due to an increase in Ees index significantly greater in women (9.4 ± 1.9 mmHg/ml/m2) than in men (6.5 ± 1.5 mmHg/ml/m2, p = 0.0002). Using multivariate regression analysis, only female gender (β coefficient −0.04, p = 0.01) and relative wall thickness (β coefficient −0.49, p < 0.0001) showed a significant inverse correlation to VA coupling. Conclusions: Our analysis in a population of centenarians without overt cardiovascular disease revealed very low values of VA coupling, especially in women. Both a LV structural remodeling as well as a high aortic elastance might have contributed to a secondary disproportionate increase in myocardial stiffness.

AB - Background: Ventricular-arterial (VA) coupling is a central determinant of cardiovascular system performance and cardiac energetics. This index is expressed by the Ea/Ees ratio, where the effective arterial elastance (Ea) indicates the net arterial load exerted on the left ventricle and the left ventricular end-systolic elastance (Ees) is a load-independent measure of left ventricular chamber performance. Methods: Thirty-three centenarians (100.6 ± 1.2 years, range 99–105 years, 10 M) without cardiovascular diseases underwent a complete echocardiographic evaluation and an instantaneous arterial blood pressure measurement, to characterize the Ea/Ees ratio and its two determinants indexed to body surface area. Results: VA coupling was markedly reduced (Ea/Ees ratio 0.40 ± 0.1), reflecting a disproportionate increase in Ees index (8.5 ± 2.2 mmHg/ml/m2) compared with Ea index (3.2 ± 0.8 mmHg/ml/m2). Notably, the coupling ratio was significantly lower in women (0.37 ± 0.1) than in men (0.45 ± 0.1, p = 0.0003), due to an increase in Ees index significantly greater in women (9.4 ± 1.9 mmHg/ml/m2) than in men (6.5 ± 1.5 mmHg/ml/m2, p = 0.0002). Using multivariate regression analysis, only female gender (β coefficient −0.04, p = 0.01) and relative wall thickness (β coefficient −0.49, p < 0.0001) showed a significant inverse correlation to VA coupling. Conclusions: Our analysis in a population of centenarians without overt cardiovascular disease revealed very low values of VA coupling, especially in women. Both a LV structural remodeling as well as a high aortic elastance might have contributed to a secondary disproportionate increase in myocardial stiffness.

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