Structural and functional status of the systemic circulation arteries in patients with pulmonary arterial hypertension
Article Sidebar
Main Article Content
Abstract
The aim – to study the elastic properties of the systemic circulation arteries in patients with pulmonary arterial hypertension (PAH).
Мaterial and methods. 111 patients were examined: 30 – with idiopathic PAH (IPAH) (1st group), 30 patients with PAH, associated with congenital heart disease (2nd group), 26 patients with arterial hypertension (3rd group) and 25 healthy controls (group 4). Pulse wave velocity was measured in the arteries of muscular (PWVm) and elastic types (PWVe), also we measured cardio-ankle vascular index (CAVI).
Results. PWVe was 26 % higher in patients with AH than in patients with IPAH, and 44 % higher than in patients with PAH associated with CHD. Right CAVI in patients with IPAH was equal to those in AH patients (7.03±0.20 versus 7.19±0.14, Р>0.2) and 16 % higher than in the control group. Left CAVI in patients with IPAH was similar to that in AH patients (7.22±0.20 versus 7.20±0.20, Р>0.2) and 17 % higher than in the control group. Patients with reduced
(< 330 m) functional abilities (FA) compared with patients with preserved (> 330 m) FA, had significantly higher arterial stiffness: the level of right СAVI was, accordingly, 7.73±0.14 vs 6.78±0.20, Р<0.005; the level of left СAVI was 8.04±0.19 vs 6.92±0.18, Р<0.0001.
Conclusions. The method of CAVI, which does not depend on the blood pressure level, helps to detect the disturbances of the elastic properties of the systemic circulation arteries in patients with IPAH. Changes of the elastic properties of arteries were more significant in patients with IPAH with significant decrease of functional abilities compared to patients with preserved FA.
Article Details
Keywords:
References
Сіренко Ю.М., Радченко Г.Д., Живило І.О. та ін. Досвід катетеризації правих відділів серця та легеневої артерії у хворих на легеневу гіпертензію // Серце і судини.– 2016.– № 4.– C. 23–29.
Bradley A.M., Leopold J.A. Emerging Concepts in the Molecular Basis of Pulmonary Arterial Hypertension: Part II: Neurohormonal Signaling Contributes to the Pulmonary Vascular and Right Ventricular Pathophenotype of Pulmonary Arterial Hypertension // Circulation.– 2015.– Vol. 131.– P. 2079–2091.
Dzau V. The cardiovascular continuum and renin-angiotensin-aldosterone system blockade // J. Hypertens.– 2005.– Vol. 23.– P. 9–17.
Galie N., Hoeper M.M., Humbert M. et al. Guidelines for the diagnosis and treatment of pulmonary hypertension: the Task Force for the Diagnosis and Treatment of Pulmonary Hypertension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS), endorsed by the International Society of Heart and Lung Transplantation (ISHLT) // Eur. Heart J.– 2009.– Vol. 30.– P. 2493–2537.
Rubin L.J., Badesch D.B. Evaluation and management of the patient with pulmonary arterial hypertension // Ann. Intern. Med.– 2005.– Vol. 143.– P. 282–292.
Shirai K., Utino J., Otsuka K. et al. A novel blood pressure-independent arterial wall stiffness parameter; cardioankle vascular index (CAVI) // J. Atheroscler. Thromb.– 2006.– Vol. 13.– P. 101–107.
Versari D., Daghini E., Virdis A. et al. Endothelium-dependent contractions and endothelial dysfunction in human hypertension // British J. Pharmacology.– 2009.– Vol. 157.– P. 527–536.
Wilkinson I.B., Cockcroft J.R., Webb D.J. Pulse wave analysis and arterial stiffness // J. Cardiovasc. Pharmacol.– 1998.– Vol. 32.– P. 33–37.