Significant Long-term Variations in Left Ventricular Ejection Fraction Driven by Systemic Vascular Resistance Changes

This study aims to determine whether changes in vascular function parameters, such as systemic vascular resistance (SVR), might explain the significant changes in LV ejection fraction (EF) that may be observed over the long term in subjects with no evident health issues.Subjects with no evident health issues except for hypertension and obesity, underwent MRI with phase-contrast sequences at baseline and at a median follow-up of 5.2 years. Longitudinal changes in EF were analyzed with regard to concomitant changes in the vascular function parameters computed with an MRI flow-sequence.A total of 118 subjects (53±12 years) were included among whom , 52% were women, 26% had hypertension, and 52 % were obese. The longitudinal change in EF was inversely related to concomitant changes in mean and diastolic blood pressure (p=0.030 and p=0.027, respectively) and much more significantly so, in SVR (p<0.001). SVR changes were -8.08±9.21 and +8.14±8.28 mmHg.min.m 2 .L -1 respectively in subjects with significant increases (n=7) and decreases (n=10) in EF, and 3.32±7.53 mmHg.min.m 2 .L -1 in subjects with stable EF (n=100) (overall p<0.001). The EF variations of populations with no evident health issues, except for hypertension and obesity, are mostly driven by concomitant changes in arterial function rather than in LV contractility. Clinical Trial Registrations. NCT01716819 and NCT02430805 on the ClinicalTrials.gov site.