(Circulation. 1997;96:1853-1858.)
© 1997 American Heart Association, Inc.
Articles |
Aortic Function in Arterial Hypertension Determined by Pressure-Diameter Relation
Effects of Diltiazem
From the Hippokration Hospital, Department of Cardiology, University of Athens, Greece.
Correspondence to Christodoulos Stefanadis, MD, FESC, FACC, 9 Tepeleniou St, 15452 Paleo Psychico, Athens, Greece.
Background Aortic elastic properties, important determinants of left ventricular function and coronary blood flow, are compromised in hypertension. The aim of this study was to determine aortic function in hypertensive patients and in normal subjects before and after administration of diltiazem, a calcium antagonist widely used in the treatment of essential hypertension.
Methods and Results The aortic pressure-diameter relation was obtained before and after diltiazem administration in 15 hypertensives and 15 control normotensives. Instantaneous diameter of the thoracic aorta was acquired with a high-fidelity intravascular catheter developed in our institution and previously validated. Instantaneous aortic pressure was measured simultaneously and at the same aortic level with a catheter-tip micromanometer. Energy loss due to the viscosity of aortic wall was measured from the area of the loop. Aortic distensibility was calculated using the formula 2x(pulsatile change in aortic diameter)/([diastolic aortic diameter]x[aortic pulse pressure]). At baseline, aortic distensibility was lower and energy loss was greater in hypertensives than in normotensives (distensibility: 1.4±0.3 versus 3.5±0.7 cm2 · dyne-1 · 10-6, respectively, P<.001; energy loss: 14.1±3.3 versus 8.2±2.2 mm · mm Hg, respectively, P<.001). After diltiazem administration, aortic distensibility was increased, whereas energy loss was decreased in both hypertensives (peak response: distensibility, 2.0±0.4 cm2 · dyne-1 · 10-6, P<.001; energy loss, 9.3±1.6 mm · mm Hg, P<.001) and normotensives (peak response: distensibility, 5.2±0.5 cm2 · dyne-1 · 10-6, P<.001; energy loss, 5.0±1.2 mm · mm Hg, P<.001).
Conclusions Aortic elastic properties are compromised and energy loss due to aortic wall viscosity is increased in hypertensives compared with normotensives. Function of the aorta is improved in both hypertensive and normotensive subjects after the administration of diltiazem.
Key Words: aorta • diltiazem • hypertension • elasticity
This article has been cited by other articles:
 |
|
 |
|
  C Vlachopoulos, K Aznaouridis, and C Stefanadis Clinical appraisal of arterial stiffness: the Argonauts in front of the Golden Fleece Heart, November 1, 2006; 92(11): 1544 - 1550. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. L. Armentano, J. G. Barra, D. B. Santana, F. M. Pessana, S. Graf, D. Craiem, L. M. Brandani, H. P. Baglivo, and R. A. Sanchez Smart Damping Modulation of Carotid Wall Energetics in Human Hypertension: Effects of Angiotensin-Converting Enzyme Inhibition Hypertension, March 1, 2006; 47(3): 384 - 390. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Dernellis and M. Panaretou Aortic Stiffness Is an Independent Predictor of Progression to Hypertension in Nonhypertensive Subjects Hypertension, March 1, 2005; 45(3): 426 - 431. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Durier, C. Fassot, S. Laurent, P. Boutouyrie, J.-P. Couetil, E. Fine, P. Lacolley, V. J. Dzau, and R. E. Pratt Physiological Genomics of Human Arteries: Quantitative Relationship Between Gene Expression and Arterial Stiffness Circulation, October 14, 2003; 108(15): 1845 - 1851. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. J. Oliver and D. J. Webb Noninvasive Assessment of Arterial Stiffness and Risk of Atherosclerotic Events Arterioscler. Thromb. Vasc. Biol., April 1, 2003; 23(4): 554 - 566. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Hager, H. Kaemmerer, U. Rapp-Bernhardt, S. Blucher, K. Rapp, T. M. Bernhardt, M. Galanski, and J. Hess Diameters of the thoracic aorta throughout life as measured with helical computed tomography J. Thorac. Cardiovasc. Surg., June 1, 2002; 123(6): 1060 - 1066. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Vlachopoulos, K. Hirata, and M. F. O'Rourke Pressure-Altering Agents Affect Central Aortic Pressures More Than Is Apparent From Upper Limb Measurements in Hypertensive Patients: The Role of Arterial Wave Reflections Hypertension, December 1, 2001; 38(6): 1456 - 1460. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B. P. Cholley, R. M. Lang, C. E. Korcarz, and S. G. Shroff Smooth muscle relaxation and local hydraulic impedance properties of the aorta J Appl Physiol, June 1, 2001; 90(6): 2427 - 2438. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Stefanadis, J. Dernellis, E. Tsiamis, L. Diamantopoulos, A. Michaelides, and P. Toutouzas Assessment of Aortic Line of Elasticity Using Polynomial Regression Analysis Circulation, April 18, 2000; 101(15): 1819 - 1825. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C Stefanadis, J Dernellis, E Tsiamis, C Stratos, L Diamantopoulos, A Michaelides, and P Toutouzas Aortic stiffness as a risk factor for recurrent acute coronary events in patients with ischaemic heart disease Eur. Heart J., March 1, 2000; 21(5): 390 - 396. [Abstract] [PDF]
|
|
|
|
 |
|
 C. Stefanadis, E. Tsiamis, J. Dernellis, and P. Toutouzas Effect of estrogen on aortic function in postmenopausal women Am J Physiol Heart Circ Physiol, February 1, 1999; 276(2): H658 - H662. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Stefanadis, J. Dernellis, E. Tsiamis, C. Stratos, I. Kallikazaros, and P. Toutouzas AORTIC FUNCTION IN PATIENTS DURING INTRA-AORTIC BALLOON PUMPING DETERMINED BY THE PRESSURE-DIAMETER RELATION J. Thorac. Cardiovasc. Surg., December 1, 1998; 116(6): 1052 - 1059. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. J. Bank and D. R. Kaiser Smooth Muscle Relaxation : Effects on Arterial Compliance, Distensibility, Elastic Modulus, and Pulse Wave Velocity Hypertension, August 1, 1998; 32(2): 356 - 359. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Stefanadis, J. Dernellis, M. Vavuranakis, E. Tsiamis, C. Vlachopoulos, Konstantinos Toutouzas, L. Diamandopoulos, C. Pitsavos, and P. Toutouzas Effects of ventricular pacing-induced tachycardia on aortic mechanics in man Cardiovasc Res, August 1, 1998; 39(2): 506 - 514. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Cattaruzza, I. Eberhardt, and M. Hecker Mechanosensitive Transcription Factors Involved in Endothelin B Receptor Expression J. Biol. Chem., September 28, 2001; 276(40): 36999 - 37003. [Abstract] [Full Text] [PDF]
|
|