1887
  1. Home
  2. A-Z Publications
  3. Global Cardiology Science and Practice
  4. Volume 2015, Issue 2
  5. Article
Volume 2015, Issue 2
  • ISSN: 2305-7823
  • EISSN:

Abstract

Ventricular-vascular coupling is an important phenomenon in many cardiovascular diseases. The association between aortic mechanical dysfunction and left ventricular (LV) dysfunction is well characterized in many disease entities, but no data are available on how these changes are related in hypertrophic cardiomyopathy (HCM). This study examined whether HCM alone is associated with an impaired aortic mechanical function in patients without cardiovascular risk factors and the relation of these changes, if any, to LV deformation and cardiac phenotype. 141 patients with HCM were recruited and compared to 66 age- and sex-matched healthy subjects as control group. Pulse pressure, aortic strain, stiffness and distensibility were calculated from the aortic diameters measured by M-mode echocardiography and blood pressure obtained by sphygmomanometer. Aortic wall systolic and diastolic velocities were measured using pulsed wave Doppler tissue imaging (DTI). Cardiac assessment included geometric parameters and myocardial deformation (strain and strain rate) and mechanical dyssynchrony. The pulsatile change in the aortic diameter, distensibility and aortic wall systolic velocity (AWS') were significantly decreased and aortic stiffness index was increased in HCM compared to control (P < .001) In HCM AWS' was inversely correlated to age(r = − .32, P < .0001), MWT (r = − .22, P < .008), LVMI (r = − .20, P < .02), E/Ea (r = − .16, P < .03) LVOT gradient (r = − 19, P < .02) and severity of mitral regurg (r = − .18, P < .03) but not to the concealed LV deformation abnormalities or mechanical dyssynchrony. On multivariate analysis, the key determinant of aortic stiffness was LV mass index and LVOT obstruction while the role LV dysfunction in aortic stiffness is not evident in this population. HCM is associated with abnormal aortic mechanical properties. The severity of cardiac phenotype, not LV deformation, is interrelated to aortic stiffness in patients with HCM. The increased aortic stiffness seems to be promising module that can be added as clinical risk parameter in HCM.

© 2015 Badran, licensee Bloomsbury Qatar Foundation Journals.
Loading

Article metrics loading...

/content/journals/10.5339/gcsp.2015.27
2015-07-03
2024-12-30
Loading full text...

Full text loading...

/deliver/fulltext/gcsp/2015/2/gcsp.2015.27.html?itemId=/content/journals/10.5339/gcsp.2015.27&mimeType=html&fmt=ahah

References

  1. Maron BJ. Hypertrophic cardiomyopathy: A systematic review. JAMA. 2002; 287:10:1308–1320. doi:10.1001/jama.287.10.1308. .
     [Google Scholar]
  2. Soliman OII, Knaapen P, Geleijnse ML, Dijkmans PA, Anwar AM, Nemes A, Michels M, Vletter WB, Lammertsma AA, ten Cate FJ. Assessment of intravascular and extravascular mechanisms of myocardial perfusion abnormalities in obstructive hypertrophic cardiomyopathy by myocardial contrast echocardiography. Heart. 2007; 93:10:1204–1212. doi:10.1136/hrt.2006.110460. .
     [Google Scholar]
  3. Heffernan KS, Napolitano CA, Maron MS, Patvardhan EA, Patel AR, Pandian NG, Karas RH, Kuvin JT. Peripheral Vascular Endothelial Function in Patients With Hypertrophic Cardiomyopathy. American Journal of Cardiology. 2010; 105:1:112–115. doi:10.1016/j.amjcard.2009.08.658. .
     [Google Scholar]
  4. Boutouyrie P, Laurent S, Briet M. Importance of arterial stiffness as cardiovascular risk factor for future development of new type of drugs. Fundamental & Clinical Pharmacology. 2008; 22:3:241–246. doi:10.1111/j.1472-8206.2008.00584.x. .
     [Google Scholar]
  5. Laurent S, Cockcroft J, Bortel LV, Boutouyrie P, Giannattasio C, Hayoz D, Pannier B, Vlachopoulos C, Wilkinson I, Struijker-Boudier H. Expert consensus document on arterial stiffness: methodological issues and clinical applications. European Heart Journal. 2006; 27:21:2588–2605. doi:10.1093/eurheartj/ehl254. .
     [Google Scholar]
  6. Boutouyrie P, Tropeano AI, Asmar R, Gautier I, Benetos A, Lacolley P, Laurent S. Aortic Stiffness Is an Independent Predictor of Primary Coronary Events in Hypertensive Patients A Longitudinal Study. Hypertension. 2002; 39:1:10–15. doi:10.1161/hy0102.099031. .
     [Google Scholar]
  7. Cruickshank K, Riste L, Anderson SG, Wright JS, Dunn G, Gosling RG. Aortic Pulse-Wave Velocity and Its Relationship to Mortality in Diabetes and Glucose Intolerance An Integrated Index of Vascular Function? Circulation. 2002; 106:16:2085–2090. doi:10.1161/01.CIR.0000033824.02722.F7. .
     [Google Scholar]
  8. Blacher J, Guerin AP, Pannier B, Marchais SJ, Safar ME, London GM. Impact of Aortic Stiffness on Survival in End-Stage Renal Disease. Circulation. 1999; 99:18:2434–2439. doi:10.1161/01.CIR.99.18.2434. .
     [Google Scholar]
  9. Sutton-Tyrrell K, Najjar SS, Boudreau RM, Venkitachalam L, Kupelian V, Simonsick EM, Havlik R, Lakatta EG, Spurgeon H, Kritchevsky S, Pahor M, Bauer D, Newman A. Study for the HA. Elevated Aortic Pulse Wave Velocity, a Marker of Arterial Stiffness, Predicts Cardiovascular Events in Well-Functioning Older Adults. Circulation. 2005; 111:25:3384–3390. doi:10.1161/CIRCULATIONAHA.104.483628. .
     [Google Scholar]
  10. Hansen TW, Staessen JA, Torp-Pedersen C, Rasmussen S, Thijs L, Ibsen H, Jeppesen J. Prognostic Value of Aortic Pulse Wave Velocity as Index of Arterial Stiffness in the General Population. Circulation. 2006; 113:5:664–670. doi:10.1161/CIRCULATIONAHA.105.579342. .
     [Google Scholar]
  11. Boonyasirinant T, Rajiah P, Setser RM, Lieber ML, Lever HM, Desai MY, Flamm SD. Aortic Stiffness Is Increased in Hypertrophic Cardiomyopathy With Myocardial FibrosisNovel Insights in Vascular Function From Magnetic Resonance Imaging. J Am Coll Cardiol. 2009; 54:3:255–262. doi:10.1016/j.jacc.2009.03.060. .
     [Google Scholar]
  12. Rerkpattanapipat P, Hundley WG, Link KM, Brubaker PH, Hamilton CA, Darty SN, Morgan TM, Kitzman DW. Relation of aortic distensibility determined by magnetic resonance imaging in patients ≥ 60 years of age to systolic heart failure and exercise capacity. American Journal of Cardiology. 2002; 90:11:1221–1225. doi:10.1016/S0002-9149(02)02838-2. .
     [Google Scholar]
  13. Maron BJ, McKenna WJ, Danielson GK, Kappenberger LJ, Kuhn HJ, Seidman CE, Shah PM, Spencer WH, Spirito P, Cate FJT, Wigle ED, Vogel RA, Abrams J, Bates ER, Brodie BR, Danias PG, Gregoratos G, Hlatky MA, Hochman JS, Kaul S, Lichtenberg RC. American College of Cardiology/European Society of Cardiology Clinical Expert Consensus Document on Hypertrophic Cardiomyopathy. European Heart Journal. 2003; 24:21:1965–1991. doi:10.1016/S0195-668X(03)00479-2.
     [Google Scholar]
  14. Vitarelli A, Giordano M, Germanò G, Pergolini M, Cicconetti P, Tomei F, Sancini A, Battaglia D, Dettori O, Capotosto L, Cicco VD, Maio MD, Vitarelli M, Bruno P. Assessment of ascending aorta wall stiffness in hypertensive patients by tissue Doppler imaging and strain Doppler echocardiography. Heart. 2010; 96:18:1469–1474. doi:10.1136/hrt.2010.198358.
     [Google Scholar]
  15. Özhan H, Yazici M, Albayrak S, Erbilen E, Bulur S, Akdemir R, Uyan C. Elastic Properties of the Ascending Aorta and Left Ventricular Function in Patients with Hypothyroidism. Echocardiography. 2005; 22:8:649–656. doi:10.1111/j.1540-8175.2005.00163.x. .
     [Google Scholar]
  16. Mahfouz Badran H, Elnoamany M. Impact of Type 2 Diabetes Mellitus on Aortic Elastic Properties in Normotensive Diabetes: Doppler Tissue Imaging Study. Journal of the American Society of Echocardiography. 2006; 19:12:1471–1481. doi:10.1016/j.echo.2006.06.004.
     [Google Scholar]
  17. Van Dalen BM, Vletter WB, Soliman OII, ten Cate FJ, Geleijnse ML. Importance of Transducer Position in the Assessment of Apical Rotation by Speckle Tracking Echocardiography. Journal of the American Society of Echocardiography. 2008; 21:8:895–898. doi:10.1016/j.echo.2008.02.001. .
     [Google Scholar]
  18. Ishikawa T. Limitations and Problems of Assessment of Mechanical Dyssynchrony in Determining Cardiac Resynchronization Therapy Indication. Circulation Journal. 2011; 75:2:465–471. doi:10.1253/circj.CJ-10-1252. .
     [Google Scholar]
  19. Agabiti-Rosei E, Mancia G, O'Rourke MF, Roman MJ, Safar ME, Smulyan H, Wang J-G, Wilkinson IB, Williams B, Vlachopoulos C. Central Blood Pressure Measurements and Antihypertensive Therapy A Consensus Document. Hypertension. 2007; 50:1:154–160. doi:10.1161/HYPERTENSIONAHA.107.090068. .
     [Google Scholar]
  20. Malayeri AA, Natori S, Bahrami H, Bertoni AG, Kronmal R, Lima JAC, Bluemke DA. Relation of Aortic Wall Thickness and Distensibility to Cardiovascular Risk Factors (from the Multi-Ethnic Study of Atherosclerosis [MESA]). American Journal of Cardiology. 2008; 102:4:491–496. doi:10.1016/j.amjcard.2008.04.010.
     [Google Scholar]
  21. Stefanadis C, Stratos C, Boudoulas H, Kourouklis C, Toutouzas P. Distensibility of the ascending aorta: comparison of invasive and non-invasive techniques in healthy men and in men with coronary artery disease. European Heart Journal. 1990; 11:11:990–996.
     [Google Scholar]
  22. Pitsavos C, Toutouzas K, Dernellis J, Skoumas J, Skoumbourdis E, Stefanadis C, Toutouzas P. Aortic stiffness in young patients with heterozygous familial hypercholesterolemia. Am. Heart J. 1998; 135:4:604–608.
     [Google Scholar]
  23. Eryol NK, Topsakal R, &Ccedil;i&ccedil;ek Y, Abaci A, Oguzhan A, Basar E, Ergin A. Color Doppler Tissue Imaging in Assessing the Elastic Properties of the Aorta and in Predicting Coronary Artery Disease. Japanese Heart Journal. 2002; 43:3:219–230. doi:10.1536/jhj.43.219. .
     [Google Scholar]
  24. Vitarelli A, Giordano M, Germanò G, Pergolini M, Cicconetti P, Tomei F, Sancini A, Battaglia D, Dettori O, Capotosto L, Cicco VD, Maio MD, Vitarelli M, Bruno P. Assessment of ascending aorta wall stiffness in hypertensive patients by tissue Doppler imaging and strain Doppler echocardiography. Heart. 2010; 96:18:1469–1474. doi:10.1136/hrt.2010.198358. .
     [Google Scholar]
  25. Wagenseil JE, Mecham RP. Vascular Extracellular Matrix and Arterial Mechanics. Physiological Reviews. 2009; 89:3:957–989. doi:10.1152/physrev.00041.2008. .
     [Google Scholar]
  26. McEniery CM, Wilkinson IB, Avolio AP. Age, Hypertension and Arterial Function. Clinical and Experimental Pharmacology and Physiology. 2007; 34:7:665–671. doi:10.1111/j.1440-1681.2007.04657.x. .
     [Google Scholar]
  27. Laurent S, Katsahian S, Fassot C, Tropeano A-I, Gautier I, Laloux B, Boutouyrie P. Aortic Stiffness Is an Independent Predictor of Fatal Stroke in Essential Hypertension. Stroke. 2003; 34:5:1203–1206. doi:10.1161/01.STR.0000065428.03209.64. .
     [Google Scholar]
  28. Hansen TW, Staessen JA, Torp-Pedersen C, Rasmussen S, Thijs L, Ibsen H, Jeppesen J. Prognostic Value of Aortic Pulse Wave Velocity as Index of Arterial Stiffness in the General Population. Circulation. 2006; 113:5:664–670. doi:10.1161/CIRCULATIONAHA.105.579342. .
     [Google Scholar]
  29. Koopman LP, McCrindle BW, Slorach C, Chahal N, Hui W, Sarkola T, Manlhiot C, Jaeggi ET, Bradley TJ, Mertens L. Interaction between Myocardial and Vascular Changes in Obese Children: A Pilot Study. Journal of the American Society of Echocardiography. 2012; 25:4:401–410e1. doi:10.1016/j.echo.2011.12.018. .
     [Google Scholar]
  30. Park HE, Youn T-J, Kim H-K, Kim Y-J, Sohn D-W, Oh B-H, Park Y-B, Cho G-Y. Different pattern of carotid and myocardial changes according to left ventricular geometry in hypertensive patients. J Hum Hypertens. 2013; 27:1:7–12. doi:10.1038/jhh.2011.115. .
     [Google Scholar]
  31. Sarkola T, Redington AN, Slorach C, Hui W, Bradley T, Jaeggi E. Assessment of vascular phenotype using a novel very-high-resolution ultrasound technique in adolescents after aortic coarctation repair and/or stent implantation: relationship to central haemodynamics and left ventricular mass. Heart. 2011; 97:21:1788–1793. doi:10.1136/hrt.2011.226241. .
     [Google Scholar]
  32. Suh SY, Kim EJ, Choi CU, Na JO, Kim SH, Kim HJ, Han SW, Chung SM, Ryu KH, Park CG, Seo HS, Oh DJ. Aortic Upper Wall Tissue Doppler Image Velocity: Relation to Aortic Elasticity and Left Ventricular Diastolic Function. Echocardiography. 2009; 26:9:1069–1074. doi:10.1111/j.1540-8175.2009.00910.x. .
     [Google Scholar]
  33. Roos CJ, Auger D, Djaberi R, Koning EJ de, Rabelink TJ, Pereira AM, Bax JJ, Delgado V, Jukema JW, Scholte AJ. Relationship between left ventricular diastolic function and arterial stiffness in asymptomatic patients with diabetes mellitus. Int J Cardiovasc Imaging. 2012; 29:3:609–616. doi:10.1007/s10554-012-0129-y. .
     [Google Scholar]
  34. Austin BA, Popovic ZB, Kwon DH, Thamilarasan M, Boonyasirinant T, Flamm SD, Lever HM, Desai MY. Aortic stiffness independently predicts exercise capacity in hypertrophic cardiomyopathy: a multimodality imaging study. Heart. 2010; 96:16:1303–1310. doi:10.1136/hrt.2009.191478. .
     [Google Scholar]
  35. Rossi A, Bonapace S, Cicoira M, Conte L, Anselmi A, Vassanelli C. Aortic stiffness: an old concept for new insights into the pathophysiology of functional mitral regurgitation. Heart Vessels. 2012; 28:5:606–612. doi:10.1007/s00380-012-0295-9. .
     [Google Scholar]
  36. Gavallér H, Sepp R, Csanády M, Forster T, Nemes A. Hypertrophic Cardiomyopathy Is Associated with Abnormal Echocardiographic Aortic Elastic Properties and Arteriograph-Derived Pulse-Wave Velocity. Echocardiography. 2011; 28:8:848–852. doi:10.1111/j.1540-8175.2011.01469.x. .
     [Google Scholar]
  37. Lantelme P, Mestre C, Lievre M, Gressard A, Milon H. Heart Rate An Important Confounder of Pulse Wave Velocity Assessment. Hypertension. 2002; 39:6:1083–1087. doi:10.1161/01.HYP.0000019132.41066.95. .
     [Google Scholar]
  38. Franklin SS. Arterial stiffness: Is it ready for prime time? Curr Cardiol Rep. 2007; 9:6:462–469. doi:10.1007/BF02938390. .
     [Google Scholar]
  39. Austin BA, Kwon DH, Dumont C, et al.  Ventricular-vascular stiffening is more strongly associated with exercise capacity compared to left ventricular outflow tract gradient in hypertrophic cardiomyopathy (abstr). J Am Coll Cardiol. 2008; 51:Suppl 1:A55.
     [Google Scholar]
/content/journals/10.5339/gcsp.2015.27
Loading
Aortic biomechanics in hypertrophic cardiomyopathy
Global Cardiology Science and Practice 2015, 27 (2015); https://doi.org/10.5339/gcsp.2015.27
/content/journals/10.5339/gcsp.2015.27
/content/journals/10.5339/gcsp.2015.27
Loading

Data & Media loading...

  • Article Type: Research Article
Keyword(s): Aortic stiffness, Hypertrophic cardiomyopathy and Vector velocity imaging
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error