Artery Research

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Volume 7, Issue 3-4, September 2013, Pages 222 - 229

Arterial stiffness, wave reflection amplitude and left ventricular afterload are increased in overweight individuals

Authors
Wilmer W. Nicholsa, *, John W. Petersena, Scott J. Denardob, Demetra D. Christouc
aDivision of Cardiovascular Medicine, Department of Medicine, University of Florida College of Medicine, Gainesville, FL, USA
bDepartment of Medicine, Division of Cardiology, Duke University, Durham, NC, USA
cDepartment of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, USA
*Corresponding author. Department of Medicine/Cardiology, University of Florida, Box 100277, Gainesville, FL 32610, USA. Tel.: +1 352 514 2567. E-mail addresses: nichoww@medicine.ufl.edu (W.W. Nichols), john.petersen@medicine.ufl.edu (J.W. Petersen), scott.denardo@duke.edu (S.J. Denardo), ddchristou@ufl.edu (D.D. Christou).
Corresponding Author
Wilmer W. Nichols
Received 19 June 2013, Revised 1 August 2013, Accepted 5 August 2013, Available Online 29 August 2013.
DOI
10.1016/j.artres.2013.08.001How to use a DOI?
Keywords
Overweight; Arterial stiffness; Wave reflections; Wasted ventricular energy; Leptin; Endothelial dysfunction
Abstract

Background: Reflected pressure waves from the lower body to the heart in overweight subjects return early and augment aortic systolic pressure and increase left ventricular (LV) afterload and wasted energy.

Methods: Central aortic pressure waves were generated from radial artery pressure waves recorded non-invasively in 176 subjects (age 52 ± 18 years). Augmentation index (Alx), an estimate of wave reflection, and LV wasted energy (Ew) were calculated from the generated aortic pressure wave. Data were collected in 88 non-diabetic, non-renal disease normotensive overweight (BMI 30 ± 5.0 kg/m2) subjects and compared to data collected from 88 normotensive normal weight (BMI 23 ± 2.1, P < 0.01) control subjects matched for gender, age, height, heart rate and ejection duration.

Results: Compared to controls, overweight subjects had higher aortic systolic (124 ± 17 vs 114 ± 14 mmHg, P < 0.001) and pulse (44 ± 16 vs 37 ± 12 mmHg, P < 0.001) blood pressures. Also, increased BMI was associated with an increase in Alx (28 ± 9.3 vs 20 ± 12%, P < 0.001), reflected wave duration (176 ± 28 vs 159 ± 30 msec, P < 0.004) and Ew (2527 ± 1732 vs 1498 ± 1375 dsc−2, P < 0.001) and a decrease in pressure wave travel time (133 ± 14 vs 143 ± 15 msec, P < 0.001). These modifications in wave reflection characteristics in overweight subjects were associated with a decrease in pulse pressure amplification (1.3 ± 0.14 vs 1.5 ± 0.29, P < 0.01).

Conclusions: Overweight subjects have a stiffer arterial system which decreases wave propagation time and causes the reflected pressure wave to arrive earlier at the heart with increased amplitude and duration. These changes in arterial function and wave reflection characteristics cause an increase in LV afterload, myocardial oxygen demand and wasted LV energy.

Copyright
© 2013 Association for Research into Arterial Structure and Physiology. Published by Elsevier B.V. All rights reserved.
Open Access
This is an open access article distributed under the CC BY-NC license.

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<Previous Article In Issue
Next Article In Issue>
Journal
Artery Research
Volume-Issue
7 - 3-4
Pages
222 - 229
Publication Date
2013/08/29
ISSN (Online)
1876-4401
ISSN (Print)
1872-9312
DOI
10.1016/j.artres.2013.08.001How to use a DOI?
Copyright
© 2013 Association for Research into Arterial Structure and Physiology. Published by Elsevier B.V. All rights reserved.
Open Access
This is an open access article distributed under the CC BY-NC license.

Cite this article

risenwbib
TY  - JOUR
AU  - Wilmer W. Nichols
AU  - John W. Petersen
AU  - Scott J. Denardo
AU  - Demetra D. Christou
PY  - 2013
DA  - 2013/08/29
TI  - Arterial stiffness, wave reflection amplitude and left ventricular afterload are increased in overweight individuals
JO  - Artery Research
SP  - 222
EP  - 229
VL  - 7
IS  - 3-4
SN  - 1876-4401
UR  - https://doi.org/10.1016/j.artres.2013.08.001
DO  - 10.1016/j.artres.2013.08.001
ID  - Nichols2013
ER  -