Ventricular-arterial coupling in centenarians without cardiovascular diseases

Area of Science:

• Cardiovascular Physiology
• Geriatric Cardiology
• Biomedical Engineering

Background:

• Ventricular-arterial (VA) coupling, assessed by the effective arterial elastance (Ea) to left ventricular end-systolic elastance (Ees) ratio, is crucial for cardiovascular performance and energetics.
• Ea represents arterial load on the left ventricle, while Ees measures ventricular contractility independently of load.

Purpose of the Study:

• To investigate VA coupling and its determinants in centenarians without cardiovascular disease.
• To characterize the Ea/Ees ratio and its components in an exceptionally old population.

Main Methods:

• Echocardiography and instantaneous arterial blood pressure measurement were performed in 33 centenarians (mean age 100.6 years).
• The Ea/Ees ratio and its determinants, Ea and Ees, were indexed to body surface area.

Main Results:

• VA coupling was markedly reduced (Ea/Ees ratio 0.40 ± 0.1) due to a disproportionate increase in Ees (8.5 ± 2.2 mmHg/ml/m²) compared to Ea (3.2 ± 0.8 mmHg/ml/m²).
• The coupling ratio was significantly lower in women (0.37 ± 0.1) than men (0.45 ± 0.1) (p=0.0003), driven by higher Ees in women.
• Female gender and relative wall thickness were inversely correlated with VA coupling.

Conclusions:

• Centenarians without overt cardiovascular disease exhibit significantly reduced VA coupling, especially women.
• This reduction may stem from left ventricular structural remodeling and increased aortic elastance, potentially leading to myocardial stiffness.