Erschienen in:
14.05.2016 | Original Article
Impact of aortic root size on left ventricular afterload and stroke volume
verfasst von:
Anders Sahlén, Nadira Hamid, Mohammed Rizwan Amanullah, Jiang Ming Fam, Khung Keong Yeo, Yee How Lau, Carolyn S. P. Lam, Zee Pin Ding
Erschienen in:
European Journal of Applied Physiology
|
Ausgabe 7/2016
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Abstract
Purpose
The left ventricle (LV) ejects blood into the proximal aorta. Age and hypertension are associated with stiffening and dilation of the aortic root, typically viewed as indicative of adverse remodeling. Based on analytical considerations, we hypothesized that a larger aortic root should be associated with lower global afterload (effective arterial elastance, EA) and larger stroke volume (SV). Moreover, as antihypertensive drugs differ in their effect on central blood pressure, we examined the role of antihypertensive drugs for the relation between aortic root size and afterload.
Methods
We studied a large group of patients (n = 1250; 61 ± 12 years; 78 % males; 64 % hypertensives) from a single-center registry with known or suspected coronary artery disease. Aortic root size was measured by echocardiography as the diameter of the tubular portion of the ascending aorta. LV outflow tract Doppler was used to record SV.
Results
In the population as a whole, after adjusting for key covariates in separate regression models, aortic root size was an independent determinant of both SV and EA. This association was found to be heterogeneous and stronger in patients taking a calcium channel blocker (CCB; 10.6 % of entire population; aortic root size accounted for 8 % of the explained variance of EA).
Conclusion
Larger aortic root size is an independent determinant of EA and SV. This association was heterogeneous and stronger in patients on CCB therapy.