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Association of arterial hemodynamics with left ventricular systolic function in hypertensive patients: A longitudinal study

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Gozdzik, AT, Jasic-Szpak, E, Michalowicz, J, Przewlocka-Kosmala, M, Sharman, JE ORCID: 0000-0003-2792-0811 and Kosmala, W 2021 , 'Association of arterial hemodynamics with left ventricular systolic function in hypertensive patients: A longitudinal study' , Advances in Clinical and Experimental Medicine , pp. 1-10 , doi: 10.17219/acem/141863.

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Abstract

Background: Left ventricular (LV) systolic impairment, particularly in the longitudinal direction, is considered an early and sensitive marker of hypertensive heart disease and increased cardiovascular risk. The evidence indicates that aortic stiffness and central hemodynamic factors are important determinants of LV performance, mediating the interaction between the heart and vascular load. Despite the existence of cross-sectional analyses linking central blood pressure (BP) parameters with LV mechanics, no longitudinal data are available which include serial measurements in the course of antihypertensive treatment.Objectives: To investigate the associations between changes in LV longitudinal and circumferential function with alterations in arterial hemodynamics and ventricular-arterial coupling (VAC) in patients with uncomplicated hypertension during a 12-month follow-up.Material and methods: In this retrospective study, 216 patients (age 64.3 ±7.6 years) underwent echocardiography including left ventricular longitudinal (GLS) and circumferential strain (GCS) analysis, brachial BP measurements, VAC (combining echocardiography and brachial BP), and arterial hemodynamics using radial tonometry at baseline and after 12 months of antihypertensive therapy. Patients were grouped into 2 subsets: with improvement in GLS (n = 103) and with deterioration in GLS (n = 113).Results: No significant differences were observed in the majority of cardiovascular, demographic or clinical characteristics between the groups. The subset with improvement in GLS demonstrated more favorable changes over follow-up in pulse wave velocity (p = 0.03), central augmentation pressure (p = 0.01) and ventricular-arterial coupling (p = 0.04) compared to patients showing deterioration in GLS. In the multivariable analysis, independent determinants of changes in GLS were: GLS at baseline (-0.48; p Conclusions: Left ventricular longitudinal and circumferential functional remodeling over time in hypertensive patients is associated with arterial hemodynamics and ventricular-arterial coupling.

Item Type: Article
Authors/Creators:Gozdzik, AT and Jasic-Szpak, E and Michalowicz, J and Przewlocka-Kosmala, M and Sharman, JE and Kosmala, W
Keywords: blood pressure, hypertension, public health, arterial hemodynamics, hypertension, longitudinal and circumferential strain, pulse wave analysis, ventricular-arterial coupling
Journal or Publication Title: Advances in Clinical and Experimental Medicine
Publisher: Uniwersytet Medyczny im. Piastow Slaskich we Wroclawiu
ISSN: 1899-5276
DOI / ID Number: 10.17219/acem/141863
Copyright Information:

Copyright 2021 Wroclaw Medical University. Licensed under Creative Commons Attribution 3.0 Unported (CC BY 3.0) https://creativecommons.org/licenses/by/3.0/

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