title: Arterial wave reflections and ventricular-vascular interaction in patients with left ventricular systolic dysfunction.
abstract: Central aortic pressure waveform (AoPW) is the summation of a forward-traveling wave generated by the left ventricle and a backward-traveling wave caused by the reflection of the forward wave. The aim of this study was to evaluate the effect of ventricular-vascular coupling on the morphology of AoPW in chronic heart failure patients with different degrees of left ventricular systolic dysfunction (LVSD) using pulse wave analysis (PWA). PWA of AoPW and left ventricular (LV) function were evaluated by applanation tonometry in 26 control subjects, in 12 patients with left ventricular ejection fraction (LVEF) ≤ 30%, and in 14 patients with LVEF > 30%. Augmentation pressure, augmentation index, wasted energy, and ejection duration were lower in patients with LVEF ≤ 30% than in those with LVEF > 30% and in control subjects. Furthermore, augmentation index showed an inverse correlation with Doppler mitral E-wave amplitude (r = -0.40; P = 0.04) and E/A ratio (r = -0.42; P = 0.03) and a direct correlation with deceleration time of mitral E-waves (r = 0.39; P = 0.04). In patients with severe LVSD (LVEF ≤ 30%), aortic wave reflections negatively interfere with LV function and induce a shortening of ejection duration. In contrast, AoPW is similar in patients with moderate LVSD (LVEF > 30%) and in control subjects.
authors.affiliation: Department of Translational Medical Sciences- Section of Internal Medicine, University of Naples Federico II.
authors.forename: Antonella
authors.initials: A
authors.lastname: Paglia
authors.forename: Laura
authors.initials: L
authors.lastname: Sasso
authors.forename: Flora
authors.initials: F
authors.lastname: Pirozzi
authors.forename: Angela
authors.initials: A
authors.lastname: Iannuzzi
authors.forename: Angelo
authors.initials: A
authors.lastname: Carlomagno
authors.forename: Pasquale
authors.initials: P
authors.lastname: Abete
authors.forename: Mario
authors.initials: M
authors.lastname: Petretta
authors.forename: Domenico
authors.initials: D
authors.lastname: Bonaduce
mesh_terms: D000368:Aged; D062186:Arterial Pressure; D003971:Diastole; D005260:Female; D006333:Heart Failure / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008365:Manometry; D008875:Middle Aged; D011446:Prospective Studies; D063177:Pulse Wave Analysis; D017534:Radial Artery / Q000503:physiopathology; D013318:Stroke Volume; D013599:Systole; D018487:Ventricular Dysfunction, Left / Q000503:physiopathology*