Reduced Systemic Arterial Compliance Impacts Significantly on Left Ventricular Afterload and Function in Aortic Stenosis
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Objectives We sought to determine to what extent systemic arterial compliance (SAC) might impact on afterload and left ventricular (LV) function in patients with aortic stenosis (AS).Background Although AS and reduced SAC may often coexist in the same patient, their relative impact on LV function is not well understood.Methods Systemic arterial compliance was calculated as the ratio of stroke volume index to arterial pulse pressure in 208 patients with at least moderate AS. As a measure of global afterload, we calculated the valvulo-arterial impedance (Zva), which theoretically accounts for the effects of both AS and SAC.Results Patients were divided into four groups: group 1, moderate AS and normal SAC (n = 77; 37%); group 2, moderate AS and low SAC (n = 50; 24%); group 3, severe AS and normal SAC (n = 45; 22%); and group 4, severe AS and low SAC (n = 36; 17%). The prevalences of LV diastolic and systolic dysfunction were 60% and 6% in group 1, 86% and 12% in group 2, 82% and 16% in group 3, and 94% and 31% in group 4. In multivariate analysis excluding Zva, energy loss index and SAC were both independent predictors of LV dysfunction, but when Zva was entered into the analyses, it became the only hemodynamic variable to be independently associated with LV dysfunction.Conclusions Reduced SAC is a frequent occurrence in elderly patients with AS, where it independently contributes to increased afterload and decreased LV function. Systemic arterial compliance should be taken into consideration when evaluating these patients with regard to diagnosis and treatment.
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Hypertension, especially systolic hypertension, is highly prevalent in AS patients, affecting 30-70%.
“Additionally, hypertension, and particularly systolic hypertension, is highly prevalent in these patients, affecting 30–70% of those with AS94;143;144.”
From Calcific aortic stenosis (2016) · cites this paper as [143]
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- Authors
- Briand, M., Dumesnil, J. G., Kadem, L., Tongue, A. G., Rieu, R., Garcia, D., & Pibarot, P.
- Affiliations
- Université Laval (CA)
- Institut de Recherche sur les Phénomènes Hors Équilibre (FR)
- Montreal Clinical Research Institute (CA)
- Venue
- Journal of the American College of Cardiology
- Publisher
- Elsevier BV
- Published
- 2005-07
- Volume
- 46
- Issue
- 2
- Pages
- 291-298
- ISSN
- 0735-1097 (ISSN-L)
- OpenAlex
- W2186188224
- Cited by
- 493
- References
- 32
- Citations by year
- 2026: 12 · 2025: 13 · 2024: 26 · 2023: 22 · 2022: 23 · 2021: 35 · 2020: 31 · 2019: 29 · 2018: 28 · 2017: 35 · 2016: 32 · 2015: 24 · 2014: 37 · 2013: 37 · 2012: 32
- FWCI
- 6.31
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of the American College of Cardiology (publishedVersion)
- PubMed (publishedVersion)
- Corpus Université Laval (Université Laval) (submittedVersion)
- Funders
- Université Laval
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Valve Diseases and Treatments
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Disease Prevention
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
- Keywords
- aortic stenosis, systemic arterial compliance, left ventricular afterload, left ventricular function, valvulo-arterial impedance, left ventricular diastolic dysfunction, left ventricular systolic dysfunction, elderly patients, pulse pressure
- MeSH terms
- Aged, Aortic Valve Stenosis, Arteries, Compliance, Electrocardiography, Female, Hemodynamics, Humans, Male, Pulse, Retrospective Studies, Stroke Volume, Prevalence, Multivariate Analysis, Case-Control Studies, Ventricular Function, Left, Ventricular Dysfunction, Left
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