Abstract 18545: Impact of Arterial Compliance and Resistance on Left Ventricular Aging in Humans
Introduction: Arterial elastance (Ea) is a lumped parameter of vascular properties that is related to arterial compliance, resistance and heart rate. While left ventricular (LV) end systolic elastance (Ees) and end diastolic elastance (Eed) are known to correlate with Ea (ventricular-arterial coupling), it is unknown how chronic changes in arterial compliance and resistance might differentially affect LV structure and function in the general population.
Hypothesis: Deconvolution of arterial load into resistive and oscillatory components may provide additional insight into age-related changes in ventricular function and remodelling.
Methods: Comprehensive echo-Doppler echocardiography was performed in 722 subjects participating in a randomly-selected community-based study at two examinations separated by 4 years, allowing for assessment of Ees, Ea, total arterial compliance and systemic vascular resistance at both examinations.
Results: Resistance and heart rate changes were the dominant contributors to Ea change over time. While longitudinal changes in arterial compliance had little impact on Ea, they were the most strongly associated with Ees change compared with changes in resistance. The combination of increased resistance and decreased compliance was associated with the largest increase in LV diastolic stiffness, an effect that was mediated by shrinkage in LV chamber volume. In contrast, subjects with both improved arterial compliance and decreased resistance displayed an increase in LV chamber volume over time, with no increase in LV Eed.
Conclusions: These data suggest that the chronic changes in systemic arterial compliance play the dominant role in promoting LV stiffening and chamber remodeling with aging. Interventions that improve arterial compliance may be more effective to prevent or mitigate the key components of cardiac aging in humans that are associated with the development of heart failure.
Author Disclosures: P. Wohlfahrt: None. M.M. Redfield: Honoraria; Modest; HFSA CME presentation. Consultant/Advisory Board; Modest; Eli Lily Co., Novartis- unpaid advisory. V. Melenovsky: None. F. Lopez-Jimenez: None. G.C. Kane: None. R.J. Rodeheffer: None. B.A. Borlaug: None.
- © 2014 by American Heart Association, Inc.