Combined increases in arterial resistance and decreases in compliance over 4 years were associated with increased left ventricular diastolic stiffness and decreased end-diastolic volume.
Cohort (n=722)
How do chronic changes in arterial compliance and resistance affect left ventricular ageing in humans?
Increases in pulsatile arterial load with ageing contribute to LV systolic stiffening, while combined pulsatile and resistive loading changes affect chamber remodelling and diastolic stiffness.
AIMS: Left ventricular systolic elastance (Ees) and diastolic elastance (Eed) correlate with arterial elastance (Ea), but it is unknown how chronic changes in arterial compliance and resistance, which determine Ea, might differentially affect cardiac properties with ageing. We sought to characterize chronic changes in pulsatile and resistive arterial load and correlate them with longitudinal changes in LV structure and function in a prospective, community-based study. METHODS AND RESULTS: Comprehensive echocardiography was performed in 722 subjects participating in a randomly selected community-based study at two examinations separated by 4 years, allowing for assessment of LV Ees, Eed, and end-diastolic volume (EDV), Ea, total arterial compliance, and systemic vascular resistance at both examinations. Chronic changes in resistance and heart rate were the dominant contributors to change in Ea. Changes in arterial compliance had little impact on changes in Ea, but were strongly associated with changes in Ees. The combination of increased resistance and decreased compliance was associated with the largest increase in LV diastolic stiffness, an effect that was mediated by a decrease in LVEDV. In contrast, subjects with both improved arterial compliance and decreased resistance displayed an increase in LVEDV over time, with no increase in LV Eed. CONCLUSION: Increases in pulsatile arterial load with ageing contribute more to LV systolic stiffening, while combined pulsatile and resistive loading changes are associated with positive and negative chamber remodelling and diastolic stiffness. Therapies designed to improve arterial resistance and particularly to enhance aortic compliance may hold promise to prevent or reverse cardiac ageing and its sequelae.
Wohlfahrt et al. (2014) conducted a cohort in Left ventricular ageing (n=722). Chronic changes in arterial compliance and resistance vs. Subjects with improved arterial compliance and decreased resistance was evaluated on Longitudinal changes in LV structure and function (LV Ees, Eed, and EDV). Combined increases in arterial resistance and decreases in compliance over 4 years were associated with increased left ventricular diastolic stiffness and decreased end-diastolic volume.