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Impact of chronic changes in arterial compliance and resistance on left ventricular ageing in humans

Peter Wohlfahrt1, Margaret M Redfield, Vojtech Melenovsky

  • 1Division of Cardiovascular Diseases, Department of Medicine, Mayo Clinic Rochester, Rochester, MN, USA; International Clinical Research Center, St. Anne's University Hospital, Brno, Czech Republic; Center for Cardiovascular Prevention of the First Faculty of Medicine, Charles University and Thomayer Hospital, Prague, Czech Republic; Department of Preventive Cardiology, Institute for Clinical and Experimental Medicine- IKEM, Prague, Czech Republic.

European Journal of Heart Failure
|November 1, 2014
PubMed

Insights

Aging increases arterial load, impacting cardiac function. Lowering arterial resistance and improving aortic compliance may prevent cardiac aging and its consequences.

Area of Science:

  • Cardiovascular Physiology
  • Aging Research
  • Biomedical Engineering

Background:

  • Arterial elastance (Ea) reflects arterial load and influences cardiac properties like left ventricular (LV) systolic elastance (Ees) and diastolic elastance (Eed).
  • The long-term effects of aging on arterial compliance and resistance and their differential impact on cardiac function remain incompletely understood.

Purpose of the Study:

  • To investigate chronic changes in pulsatile and resistive arterial load over time.
  • To correlate these arterial load changes with longitudinal alterations in LV structure and function in a community-based cohort.

Main Methods:

  • Prospective, community-based study involving 722 subjects.
  • Comprehensive echocardiography performed at two time points, 4 years apart.
  • Assessment of LV Ees, Eed, end-diastolic volume (EDV), Ea, arterial compliance, and systemic vascular resistance.

Main Results:

  • Chronic changes in systemic vascular resistance and heart rate were primary drivers of arterial elastance (Ea) changes.
  • Arterial compliance changes had minimal effect on Ea but were strongly linked to LV systolic elastance (Ees) changes.
  • Increased resistance and decreased compliance correlated with heightened LV diastolic stiffness, mediated by reduced LV end-diastolic volume (LVEDV).
  • Improved arterial compliance and decreased resistance were associated with increased LVEDV and no change in LV diastolic elastance (Eed).

Conclusions:

  • Increased pulsatile arterial load with aging contributes significantly to LV systolic stiffening.
  • Combined changes in pulsatile and resistive arterial loading are associated with cardiac chamber remodeling and diastolic stiffness.
  • Therapeutic strategies targeting arterial resistance and enhancing aortic compliance may offer potential for mitigating cardiac aging and related conditions.
Abstract

Keywords:
AgeingArterial complianceArterial resistanceHeart failureHeart failure with preserved ejection fractionLeft ventricular stiffness

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