Cardiac cycle-dependent changes in aortic area and distensibility are reduced in older patients with isolated diastolic heart failure and correlate with exercise intolerance
Journal of the American College of CardiologyPublished 1 September 2001
W. Gregory Hundley, Dalane W Kitzman, Timothy M. Morgan, Craig A. Hamilton, Stephen Darty, Kathryn P. Stewart
Citations385
SJR quartileQ1
SJR score9.02
SNIP6.30
Generate an AI Snapshot to get a quick, structured summary of this paper.
Study Snapshot
ObjectiveStudy objective
MethodsResearch methodology
PopulationPopulation studied
Sample sizeSample sizes
OutcomesStudy outcomes here
ResultsStudy results comes here
LimitationsResearch study limitations comes here
A concise AI-generated summary of the paper will appear here once you click Generate AI Snapshot.
TL;DR
Older patients with isolated DHF have reduced cardiac cycle-dependent changes in proximal thoracic aortic area and distensibility (beyond that which occurs with normal aging), and this correlates with and may contribute to their severe exercise intolerance.
Abstract
Older patients with isolated DHF have reduced cardiac cycle-dependent changes in proximal thoracic aortic area and distensibility (beyond that which occurs with normal aging), and this correlates with and may contribute to their severe exercise intolerance.
Keywords
Medicine
General Pharmacology The Vascular SystemMcDonald's blood flow in arteries; theoretical, experimental and clinical principles
2,400 Citations1992
The nature and flow of a fluid properties of the normanl arterial wall changes to properties of that wall pulsatile pressure flow relationships measuring principles of arterial waves ultrasonic techniques and measurements contour of pressure and flow waves in arteries wave reflection are studied.
CirculationHemodynamic Patterns of Age-Related Changes in Blood Pressure
2,312 Citations1997Stanley S. Franklin, William Gustin +5 more
The late fall in DBP after age 60 years, associated with a continual rise in SBP, cannot be explained by "burned out" diastolic hypertension or by "selective survivorship" but is consistent with increased large artery stiffness.
Journal of the American College of CardiologyCongestive heart failure in subjects with normal versus reduced left ventricular ejection fraction
1,338 Citations1999Ramachandran S. Vasan, Martin G Larson, ScD +4 more
Although CHF cases with normal LVEF have a lower mortality risk than cases with reduced LVEF, they have a fourfold mortality risk compared with control subjects who are free of CHF.
CirculationCongestive Heart Failure in the Community
1,091 Citations1998Michele Senni, Christophe M Tribouilloy +5 more
CHF is a disease of the "very elderly," frequently occurs in the setting of normal ejection fraction, and has a poor prognosis, regardless of the level of systolic function.
CirculationEffects of age and aerobic capacity on arterial stiffness in healthy adults.
1,081 Citations1993Peter Vaitkevicius, Jerome L. Fleg +6 more
Interventions to improve aerobic capacity may mitigate the stiffening of the arterial tree that accompanies normative aging, as shown in the example of endurance trained older men relative to their less active age peers.
Circulation ResearchCardiomyopathy of the aging human heart. Myocyte loss and reactive cellular hypertrophy.
771 Citations1991G Olivetti, M Melissari +2 more
Regression analysis demonstrated that the aging process was characterized by a loss of 38 million and 14 million myocyte nuclei/yr in the left and right ventricular myocardium, respectively, which may represent the structural basis for the reduced compensatory capacity of the aged heart.
New England Journal of MedicineThe Pathogenesis of Acute Pulmonary Edema Associated with Hypertension
738 Citations2001Sanjay Gandhi, John C. Powers +5 more
In patients with hypertensive pulmonary edema, a normal ejection fraction after treatment suggests that the edema was due to the exacerbation of diastolic dysfunction by hypertension--not to transient systolic dysfunction or mitral regurgitation.
Journal of the American College of CardiologyExercise intolerance in patients with heart failure and preserved left ventricular systolic function: Failure of the Frank-Starling mechanism
693 Citations1991Dalane W. Kitzman, Michael B. Higginbotham +3 more
Invasive cardiopulmonary exercise testing was performed in patients who presented with congestive heart failure, normal left ventricular ejection fraction and no significant coronary or valvular heart disease and in 10 age-matched normal subjects, and patients demonstrated a shift of theleft ventricular end-diastolic pressure-volume relation upward and to the left at rest.
The American Journal of CardiologyImportance of heart failure with preserved systolic function in patients ≥65 years of age
630 Citations2001Dalane W. Kitzman, Julius M. Gardin +8 more
The finding that a large proportion of elderly with CHF have preserved LV systolic function is important because there is a paucity of data to guide management in this dominant subset of population-based data.
CirculationEchocardiographic assessment of a normal adult aging population.
579 Citations1977Gary Gerstenblith, James W. Frederiksen +4 more
It is suggested that aging in the normal male is associated with alteredleft ventricular diastolic filling, increased aortic root diameter and left ventricular hypertrophy but little change in contractile ability in the resting state.
Journal of the American College of CardiologyCoupled systolic-ventricular and vascular stiffening with age
451 Citations1998Chen-Huan Chen, Masaru Nakayama +4 more
Combined stiffening with age is matched by ventricular systolic stiffening even without hypertrophy and could further enhance pressure lability with diuretics and postural shifts in the elderly.
CirculationExercise intolerance in patients with chronic heart failure: role of impaired nutritive flow to skeletal muscle.
451 Citations1984John R. Wilson, Jack L. Martin +2 more
The data suggest that the reduced maximal exercise capacity of patients with chronic heart failure is primarily due to impaired nutritive flow to skeletal muscle and resultant muscular fatigue.
Journal of the American College of CardiologyExercise Intolerance in Patients With Heart Failure
445 Citations2019Marco Giuseppe Del Buono, Ross Arena +9 more
The different modalities to quantify exercise intolerance, the pathophysiology of HF, and comorbid conditions as they lead to reductions in exercise and functional capacity are reviewed, highlighting the fact that distinct causes may coexist and variably contribute to exercise intolerance in patients with HF.
CirculationIncreased exercise ventilation in patients with chronic heart failure: intact ventilatory control despite hemodynamic and pulmonary abnormalities.
438 Citations1988Michael Sullivan, Michael B. Higginbotham +1 more
The demonstration of a correlation between decreased cardiac output and increased ventilation in the patient group suggests that attenuated pulmonary perfusion may play a role in causing exercise hyperpnea in the presence of chronic heart failure by producing ventilation perfusion abnormalities and thereby increasing physiologic pulmonary dead space.
The American Journal of CardiologyEffects of age on ventricular-vascular coupling
345 Citations1985Wilmer W. Nichols, Michael F. O’Rourke +5 more
Changes in the impedance spectral pattern indicate that the ascending aorta becomes stiffer and the cross section of the peripheral vascular bed decreases with age, causing increased pulse wave velocity and wave reflection.
CirculationCardiac hypertrophy, aortic compliance, peripheral resistance, and wave reflection in end-stage renal disease. Comparative effects of ACE inhibition and calcium channel blockade.
335 Citations1994Gérard M. London, Bruno Pannier +4 more
In ESRD patients with LVH, ACE inhibition decreases LVM independently of its antihypertensive effect and of associated alterations in arterial hemodynamics, which may have resulted in these patients from chronic volume overload.
CirculationIn Vivo Magnetic Resonance Evaluation of Atherosclerotic Plaques in the Human Thoracic Aorta
321 Citations2000Zahi A. Fayad, Tamana Nahar +7 more
This study demonstrates that noninvasive MR evaluation of the aorta compares well with TEE imaging for the assessment of atherosclerotic plaque thickness, extent, and composition.
CirculationExercise training in patients with chronic heart failure delays ventilatory anaerobic threshold and improves submaximal exercise performance.
298 Citations1989Michael Sullivan, Michael B. Higginbotham +1 more
The training-induced decrease in lactate accumulation was accompanied by a decrease in carbon dioxide production, respiratory exchange ratio, and ventilation during submaximal exercise and the ventilatory response to exercise in patients with chronic heart failure.
The American Journal of CardiologyChanges in aortic distensibility and pulse wave velocity assessed with magnetic resonance imaging following beta-blocker therapy in the marfan syndrome
276 Citations1998Maarten Groenink, Albert de Roos +3 more
Aortic stiffness in Marfan syndrome, together with mean blood pressure, is reduced by beta-blocker therapy, and MRI is well suited to detect these changes by measuring distensibility and pulse wave velocity.
CirculationPrevalence and prognostic significance of exercise-induced silent myocardial ischemia detected by thallium scintigraphy and electrocardiography in asymptomatic volunteers.
266 Citations1990Jerome L. Fleg, Gary Gerstenblith +5 more
CirculationMagnetic Resonance Imaging Assessment of the Severity of Mitral Regurgitation
230 Citations1995W. Gregory Hundley, Hong F. Li +6 more
Magnetic resonance imaging compares favorably with cardiac catheterization for assessment of the magnitude of regurgitation and its influence on left ventricular volumes and systolic function.
Progress in Cardiovascular DiseasesExercise intolerance in patients with chronic heart failure
185 Citations1995Martin J. Sullivan, Mary H. Hawthorne
The results suggest that exercise intolerance in patients with CHF is multifactorial, and that research efforts must consider central hemodynamic abnormalities, pulmonary abnormalities, and alterations in peripheral blood flow and skeletal muscle biochemistry and histology.
Cardiovascular ResearchEffects of hypertension on the static mechanical properties and chemical composition of the rat aorta
165 Citations1976C. L. Berry, Stephen E. Greenwald
Evidence is shown of adaptive changes in the aorta of hypertensive animals, and that irreversible alterations in the mechanical properties of the wall may be induced by a brief period of hypertension.
Annals of Internal MedicineHemodynamic Determinants of Exercise Capacity in Chronic Heart Failure
140 Citations1991Jonathan S. Myers, Victor F. Froelicher
Systolic function and exercise capacity are unrelated in patients with chronic heart failure, but many hemodynamic abnormalities overlap, which leads to exercise intolerance in these patients.
Journal of the American College of CardiologyVerapamil acutely reduces ventricular-vascular stiffening and improves aerobic exercise performance in elderly individuals
108 Citations1999Chen-Huan Chen, Masaru Nakayama +6 more
Acute intravenous verapamil reduces ventriculovascular stiffening and improves aerobic exercise performance in healthy aged individuals, suggesting a potentially therapeutic target for aged individuals with exertional limitations.
PubMedArterial dynamics, cardiac hypertrophy, and antihypertensive treatment.
104 Citations1987Safar Me, Toto-Moukouo Jj +5 more
Journal of Applied PhysiologyEvidence that the metabolic acidosis threshold is the anaerobic threshold
89 Citations1990Atsushi Koike, Daniel Weiler‐Ravell +3 more
VO2 was unchanged related to work rate below the metabolic acidosis threshold during the tests with increased HbCO but was reduced at the work rates above the metabolic Acidosis threshold, consistent with the concept that the metabolic acidsosis threshold is synonymous with an anaerobic threshold.
The American Journal of CardiologyReproducibility of cardiopulmonary exercise testing in elderly patients with congestive heart failure
74 Citations1998ChristianT Marburger, P. H. Brubaker +3 more
Elderly patients with congestive heart failure, including those with preserved systolic function, underwent maximal cardiopulmonary exercise testing and showed good reproducibility.
The American Journal of MedicineAscending aorta distensibility abnormalities in hypertensive patients and response to nifedipine administration
73 Citations1992Costas Stratos, Christodoulos Stefanadis +3 more
Nifedipine administration increased the distensibility of the ascending aorta both in patients with arterial hypertension and in normotensive subjects, and the increase of aorticdistensibility after nifedIPine administration was lower in hypertensive patients.
American Journal of Physiology-Heart and Circulatory PhysiologyHemodynamic effects of unloading the old heart
59 Citations1999Amit Nussbacher, Gary Gerstenblith +6 more
Combined preload and afterload reduction with NP in older individuals improves overall LV ejection phase function: exercise LV stroke work is reduced, EF is increased, and stroke volume is maintained in the setting of a reduced ventricular size.
CirculationDifferential Effects of Chronic Oral Antihypertensive Therapies on Systemic Arterial Circulation and Ventricular Energetics in African-American Patients
51 Citations1995Bernard Cholley, Sanjeev G. Shroff +8 more
A reduction in MVO2 coupled with unchanged total vascular mechanical power suggests improved efficiency of ventriculoarterial coupling with ramipril and with nifedipine in the subset of patients in whom heart rate remained unchanged.
Exercise Intolerance in Patients with Heart Failure: Role of Diastolic Dysfunction
5 Citations1994Dalane W. Kitzman, Martin J. Sullivan
Cardiac output increased 3.2-fold during exercise in normal subjects, and the increased stroke volume was due to the Frank— Starling mechanism and increased contractility.
