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This Article Full Text Full Text (PDF) All Versions of this Article: 295/1/H145    most recent 01179.2007v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Google Scholar Articles by Chantler, P. D. Articles by Najjar, S. S. PubMed PubMed Citation Articles by Chantler, P. D. Articles by Najjar, S. S.

The sex-specific impact of systolic hypertension and systolic blood pressure on arterial-ventricular coupling at rest and during exercise

¹Laboratory of Cardiovascular Science, National Institute on Aging, National Institutes of Health (NIH), Baltimore, Maryland; ²Department of Cardiology, Institute of Clinical and Experimental Medicine, Prague, Czech Republic; ³Division of Cardiology, Department of Medicine, Johns Hopkins Medical Institutions, Baltimore; ⁴Longitudinal Studies Section, Clinical Research Branch, National Institute on Aging, NIH, Baltimore; and ⁵Division of Cardiovascular Diseases, National Heart, Lung, and Blood Institute, Bethesda, Maryland

Submitted 10 October 2007 ; accepted in final form 28 April 2008

In healthy subjects the arterial system and the left ventricle (LV) are tightly coupled at rest to optimize cardiac performance. Systolic hypertension (SH) is a major risk factor for heart failure and is associated with structural and functional alterations in the arteries and the LV. The effects of SH and resting systolic blood pressure (SBP) on arterial-ventricular coupling (E_aI/E_LVI) at rest, at peak exercise, and during recovery are not well described. We noninvasively characterized E_aI/E_LVI as end-systolic volume index/stroke volume index in subjects who were normotensive (NT, n = 203) or had SH (brachial SBP 140 mmHg, n = 79). Cardiac volumes were measured at rest and throughout exhaustive upright cycle exercise with gated blood pool scans. E_aI/E_LVI reserve was calculated by subtracting peak from resting E_aI/E_LVI. At rest, E_aI/E_LVI did not differ between SH and NT men but was 23% (P = 0.001) lower in SH vs. NT women. E_aI/E_LVI did not differ between SH and NT men or women at peak exercise or during recovery. Nevertheless, E_aI/E_LVI reserve was 61% (P < 0.001) lower in SH vs. NT women. Similarly, resting SBP (as a continuous variable) was not associated with E_aI/E_LVI in men (β = –0.12, P = 0.17) but was inversely associated with E_aI/E_LVI in women (β = –0.47, P < 0.001). SH and a higher resting brachial SBP are associated with a lower E_aI/E_LVI at rest in women but not in men, and SH women have an attenuated E_aI/E_LVI reserve. Whether a smaller E_aI/E_LVI reserve leads to functional limitations warrants further examination.

arterial elastance; left ventricular end-systolic elastance; systolic hypertension; exercise; sex

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				P. D. Chantler, E. G. Lakatta, and S. S. Najjar Arterial-ventricular coupling: mechanistic insights into cardiovascular performance at rest and during exercise J Appl Physiol, October 1, 2008; 105(4): 1342 - 1351. [Abstract] [Full Text] [PDF]