Cardiac cycle-dependent changes in aortic area and distensibility are reduced in older patients with isolated diastolic heart failure and correlate with exercise intolerance

OBJECTIVES The goal of this study was to determine if cardiac cycle-dependent changes in proximal thoracic aortic area and distensibility are associated with exercise intolerance in elderly patients with diastolic heart failure (DHF). BACKGROUND Aortic compliance declines substantially with age. We...

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Published in:Journal of the American College of Cardiology 2001-09, Vol.38 (3), p.796-802
Main Authors: Hundley, W.Gregory, Kitzman, Dalane W, Morgan, Timothy M, Hamilton, Craig A, Darty, Stephen N, Stewart, Kathryn P, Herrington, David M, Link, Kerry M, Little, William C
Format: Article
Language:English
Subjects:
Adult
Aorta, Thoracic - pathology
Elasticity
Exercise Test
Exercise Tolerance
Female
Heart Failure - pathology
Heart Failure - physiopathology
Humans
Magnetic Resonance Imaging
Male
Oxygen Consumption
Ventricular Dysfunction, Left - pathology
Ventricular Dysfunction, Left - physiopathology
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cited_by cdi_FETCH-LOGICAL-c494t-c9161e1e85113db4779e76b292770a730be68ea75d64f40f190e20c58e73fdd03
cites cdi_FETCH-LOGICAL-c494t-c9161e1e85113db4779e76b292770a730be68ea75d64f40f190e20c58e73fdd03
container_end_page 802
container_issue 3
container_start_page 796
container_title Journal of the American College of Cardiology
container_volume 38
creator Hundley, W.Gregory
Kitzman, Dalane W
Morgan, Timothy M
Hamilton, Craig A
Darty, Stephen N
Stewart, Kathryn P
Herrington, David M
Link, Kerry M
Little, William C
description OBJECTIVES The goal of this study was to determine if cardiac cycle-dependent changes in proximal thoracic aortic area and distensibility are associated with exercise intolerance in elderly patients with diastolic heart failure (DHF). BACKGROUND Aortic compliance declines substantially with age. We hypothesized that a reduction in cardiac cycle-dependent changes in thoracic aortic area and distensibility (above that which occurs with aging) could be associated with the exercise intolerance that is prominent in elderly diastolic heart failure patients. METHODS Thirty subjects (20 healthy individuals [10 < 30 years of age and 10 > 60 years of age] and 10 individuals > the age of 60 years with DHF) underwent a magnetic resonance imaging (MRI) study of the heart and proximal thoracic aorta followed within 48 h by maximal exercise ergometry with expired gas analysis. RESULTS The patients with DHF had higher resting brachial pulse and systolic blood pressure, left ventricular mass, aortic wall thickness and mean aortic flow velocity, and, compared with healthy older subjects, they had a significant reduction in MRI-assessed cardiac cycle-dependent change in aortic area and distensibility (p < 0.0001) that correlated with diminished peak exercise oxygen consumption (r = 0.79). After controlling for age and gender in a multivariate analysis, thoracic aortic distensibility was a significant predictor of peak exercise oxygen consumption (p < 0.04). CONCLUSIONS Older patients with isolated DHF have reduced cardiac cycle-dependent changes in proximal thoracic aortic area and distensibility (beyond that which occurs with normal aging), and this correlates with and may contribute to their severe exercise intolerance.
doi_str_mv 10.1016/S0735-1097(01)01447-4
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BACKGROUND Aortic compliance declines substantially with age. We hypothesized that a reduction in cardiac cycle-dependent changes in thoracic aortic area and distensibility (above that which occurs with aging) could be associated with the exercise intolerance that is prominent in elderly diastolic heart failure patients. METHODS Thirty subjects (20 healthy individuals [10 &lt; 30 years of age and 10 &gt; 60 years of age] and 10 individuals &gt; the age of 60 years with DHF) underwent a magnetic resonance imaging (MRI) study of the heart and proximal thoracic aorta followed within 48 h by maximal exercise ergometry with expired gas analysis. RESULTS The patients with DHF had higher resting brachial pulse and systolic blood pressure, left ventricular mass, aortic wall thickness and mean aortic flow velocity, and, compared with healthy older subjects, they had a significant reduction in MRI-assessed cardiac cycle-dependent change in aortic area and distensibility (p &lt; 0.0001) that correlated with diminished peak exercise oxygen consumption (r = 0.79). After controlling for age and gender in a multivariate analysis, thoracic aortic distensibility was a significant predictor of peak exercise oxygen consumption (p &lt; 0.04). 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BACKGROUND Aortic compliance declines substantially with age. We hypothesized that a reduction in cardiac cycle-dependent changes in thoracic aortic area and distensibility (above that which occurs with aging) could be associated with the exercise intolerance that is prominent in elderly diastolic heart failure patients. METHODS Thirty subjects (20 healthy individuals [10 &lt; 30 years of age and 10 &gt; 60 years of age] and 10 individuals &gt; the age of 60 years with DHF) underwent a magnetic resonance imaging (MRI) study of the heart and proximal thoracic aorta followed within 48 h by maximal exercise ergometry with expired gas analysis. 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BACKGROUND Aortic compliance declines substantially with age. We hypothesized that a reduction in cardiac cycle-dependent changes in thoracic aortic area and distensibility (above that which occurs with aging) could be associated with the exercise intolerance that is prominent in elderly diastolic heart failure patients. METHODS Thirty subjects (20 healthy individuals [10 &lt; 30 years of age and 10 &gt; 60 years of age] and 10 individuals &gt; the age of 60 years with DHF) underwent a magnetic resonance imaging (MRI) study of the heart and proximal thoracic aorta followed within 48 h by maximal exercise ergometry with expired gas analysis. RESULTS The patients with DHF had higher resting brachial pulse and systolic blood pressure, left ventricular mass, aortic wall thickness and mean aortic flow velocity, and, compared with healthy older subjects, they had a significant reduction in MRI-assessed cardiac cycle-dependent change in aortic area and distensibility (p &lt; 0.0001) that correlated with diminished peak exercise oxygen consumption (r = 0.79). After controlling for age and gender in a multivariate analysis, thoracic aortic distensibility was a significant predictor of peak exercise oxygen consumption (p &lt; 0.04). 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subjects Adult
Aorta, Thoracic - pathology
Elasticity
Exercise Test
Exercise Tolerance
Female
Heart Failure - pathology
Heart Failure - physiopathology
Humans
Magnetic Resonance Imaging
Male
Oxygen Consumption
Ventricular Dysfunction, Left - pathology
Ventricular Dysfunction, Left - physiopathology
title Cardiac cycle-dependent changes in aortic area and distensibility are reduced in older patients with isolated diastolic heart failure and correlate with exercise intolerance
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