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Article Dans Une Revue AJP - Heart and Circulatory Physiology Année : 2019

Left ventricular and proximal aorta coupling in magnetic resonance imaging: aging together?

Résumé

The importance of aorta-ventricular coupling in cardiovascular disease is recognized but underestimated. The contribution of the age-related decline in ascending aortic function compared with characteristic impedance and total peripheral resistance on left ventricular function and remodeling is poorly studied. Our aim was to evaluate the relation of proximal aortic distensibility and impedance with left ventricular geometry and function in asymptomatic individuals. We prospectively studied 100 subjects (47 men, 53 women, age: 20–84 yr). Aortic strain, distensibility, arch pulse wave velocity, characteristic impedance (Zc), total peripheral resistance, left ventricular (LV) volumes and mass, wall stress, and peak global circumferential myocardial strain and strain rates were determined by MRI. Central pressures were measured from tonometry. Ea/Ev, an index of vascular-ventricular coupling, and LV wall stress were preserved across age- or aortic-stiffness-stratified groups. Static and pulsatile components of aortic load were differentially associated with age. Increased total vascular resistance was associated with decreased LV strain and increased concentric remodeling [ratio of LV mass to end-diastolic volume (M/V ratio)] in all individuals. In younger individuals (<45 yr), aortic distensibility was related to LV strain and concentric remodeling (M/V ratio), whereas Zc was related to LV strain and concentric remodeling (M/V ratio) in older individuals (>45 yr). Early age-related stiffening of the ascending aorta is a component of LV afterload subsequently associated with increased aortic impedance and alterations in LV geometry, namely concentric remodeling, decreased myocardial strain, and increased stroke work such that LV wall stress and arterial-ventricular coupling are preserved.

Dates et versions

hal-02633225 , version 1 (27-05-2020)

Identifiants

Citer

Alban Redheuil, Nadjia Kachenoura, Emilie Bollache, Wen-Chung Yu, Anders Opdahl, et al.. Left ventricular and proximal aorta coupling in magnetic resonance imaging: aging together?. AJP - Heart and Circulatory Physiology, 2019, 317 (2), pp.H300-H307. ⟨10.1152/ajpheart.00694.2018⟩. ⟨hal-02633225⟩
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