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Ventricular‐arterial coupling and arterial‐baroreflex function in patients with heart failure and normal ejection fraction
Author(s) -
Shibata Shigeki,
Okazaki Kazunobu,
Zhang Rong,
Prasad Anand,
ArbabZadeh Armin,
Hastings Jeff,
Dorfman Todd,
Fu Qi,
Conner Colin,
Shook Robin,
Palmer M. Dean,
Levine Benjamin D.
Publication year - 2006
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.20.5.a1197-a
Subject(s) - preload , cardiology , medicine , baroreflex , ejection fraction , blood pressure , heart failure , heart rate , diastole , hemodynamics , anesthesia
Changes in ventricular‐arterial coupling may lead to diastolic dysfunction with aging. Arterial‐baroreflex function is impaired in heart failure. It is unknown whether these characteristics are more or less impaired in patients with heart failure but a normal ejection fraction (CHF‐nlEF). Methods Five CHF‐nlEF subjects (74±8 yrs, mean±SD) were compared with 6 age‐ and gender‐matched controls (68±3 yrs). High frequency (0.15–0.25 Hz) transfer function gains between beat‐to‐beat changes in the pulmonary artery diastolic pressure (Swan‐Ganz catheter, approximating beat‐to‐beat changes in LV end‐diastolic pressure, LVEDP) and systemic arterial systolic pressure (SBP, Finapres) (Gain LVEDP‐SBP), and between the SBP and R‐R interval (RR, 3‐lead ECG) (Gain SBP‐RR) were estimated during 6 min fixed rate (0.2 Hz) respiration. Results Gain LVEDP‐ SBP (ventricular‐arterial coupling) was decreased in CHF‐nlEF compared with control (CHF‐nlEF, 0.56±0.31; Control, 0.97±0.30 mmHg/mmHg). However, Gain SBP‐RR (arterial‐baroreflex function) was not different (CHF‐nlEF, 4.9±3.8; Control, 5.4±3.2 msec/mmHg) both of which are substantially reduced compared to young subjects in our lab (21.1±14.4 msec/mmHg, N=5). Conclusion The combination of abnormal ventricular‐arterial coupling and impaired baroreflex function may represent the substrate which leads to CHF‐nlEF in the elderly.