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Impact of tachycardia and sympathetic stimulation by cold pressor test on cardiac diastology and arterial function in elderly females
KTH, School of Technology and Health (STH), Medical Engineering.ORCID iD: 0000-0002-5156-2535
KTH, School of Technology and Health (STH), Medical Engineering.
KTH, School of Technology and Health (STH), Medical Engineering.
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2013 (English)In: American Journal of Physiology. Heart and Circulatory Physiology, ISSN 0363-6135, E-ISSN 1522-1539, Vol. 304, no 7, p. H1002-H1009Article in journal (Refereed) Published
Abstract [en]

Johnson J, Hakansson F, Shahgaldi K, Manouras A, Norman M, Sahlen A. Impact of tachycardia and sympathetic stimulation by cold pressor test on cardiac diastology and arterial function in elderly females. Am J Physiol Heart Circ Physiol 304: H1002-H1009, 2013. First published January 25, 2013; doi:10.1152/ajpheart.00837.2012.-Abnormal vascular-ventricular coupling has been suggested to contribute to heart failure with preserved ejection fraction in elderly females. Failure to increase stroke volume (SV) during exercise occurs in parallel with dynamic changes in arterial physiology leading to increased afterload. Such adverse vascular reactivity during stress may reflect either sympathoexcitation or be due to tachycardia. We hypothesized that afterload elevation induces SV failure by transiently attenuating left ventricular relaxation, a phenomenon described in animal research. The respective roles of tachycardia and sympathoexcitation were investigated in n = 28 elderly females (70 +/- 4 yr) carrying permanent pacemakers. At rest, during atrial tachycardia pacing (ATP; 100 min(-1)) and during cold pressor test (hand immersed in ice water), we performed Doppler echocardiography (maximal untwist rate analyzed by speckle tracking imaging of rotational mechanics) and arterial tonometry (arterial stiffness estimated as augmentation index). Estimation of arterial compliance was based on an exponential relationship between arterial pressure and volume. We found that ATP produced central hypovolemia and a reduction in SV which was larger in patients with stiffer arteries (higher augmentation index). There was an associated adverse response of arterial compliance and vascular resistance during ATP and cold pressor test, causing an overall increase in afterload, but nonetheless enhanced maximal rate of untwist and no evidence of afterload-dependent failure of relaxation. In conclusion, tachycardia and cold provocation in elderly females produces greater vascular reactivity and SV failure in the presence of arterial stiffening, but SV failure does not arise secondary to afterload-dependent attenuation of relaxation.

Place, publisher, year, edition, pages
2013. Vol. 304, no 7, p. H1002-H1009
Keywords [en]
aging, augmentation index, diastolic function, hypertension
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:kth:diva-122100DOI: 10.1152/ajpheart.00837.2012ISI: 000317002500010Scopus ID: 2-s2.0-84878541611OAI: oai:DiVA.org:kth-122100DiVA, id: diva2:621339
Note

QC 20130514

Available from: 2013-05-14 Created: 2013-05-13 Last updated: 2017-12-06Bibliographically approved
In thesis
1. The Cardiac State Diagram: A new method for assessing cardiac mechanics
Open this publication in new window or tab >>The Cardiac State Diagram: A new method for assessing cardiac mechanics
2015 (English)Doctoral thesis, comprehensive summary (Other academic)
Place, publisher, year, edition, pages
Stockholm: KTH Royal Institute of Technology, 2015. p. 107
Series
TRITA-STH ; 2015:2
Keywords
Cardiac State Diagram, Heart, Hydraulic, Mechanics, DAPP, DeltaV, Hydraulic forces, left ventricular, diastole
National Category
Engineering and Technology
Research subject
Applied Medical Technology
Identifiers
urn:nbn:se:kth:diva-202743 (URN)978-91-7595-477-6 (ISBN)
Public defence
2015-04-27, 3-221, Alfred Nobels Alle10, Huddinge, 15:57 (Swedish)
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Supervisors
Note

QC 20170306

Available from: 2017-03-06 Created: 2017-03-04 Last updated: 2017-03-06Bibliographically approved

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