P249Effect of arterial stiffness on the initial ventricular power in mitral regurgitation


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Abstract

Purpose: In chronic mitral regurgitation (MR), afterload is alleviated through regurgitation to the atrium, which maintains the end-systolic volume (LVESV) unchanged. However, since arterial stiffness works as afterload from the beginning of ejection, an increase in stiffness may deteriorate initial ventricular power. Wave intensity (WI) is defined as the product of time derivatives of blood pressure (P) and blood velocity (U): WI = (dP/dt)(dU/dt). The highest value of WI (Wf) increases with an increase in cardiac contractility and is used as an index of initial ventricular power. The purpose of this study was to evaluate the relationship between arterial stiffness and Wf in MR.Methods: We measured carotid arterial stiffness parameter, β, and the maximum value of wave intensity (Wf) using ultrasonic system, and also measured echocardiographic indices before and after surgery in 70 patients with MR (46 men, age 51±14 years). Age matched normal data were used for comparison.Results: Wf before surgery (8.7 × 103 ± 3.9 x 103 mmHg m /s3, mean±SD) was negatively correlated with β in MR(y=−464 × + 17.4 × 103, r=0.48, p<0.0001) but not in the normal group. RV systolic pressure before surgery (41±15 mmHg) was positively correlated with β (y=0.76 × + 30, r=0.30, p<0.05) but there was no correlation between them after surgery.Conclusion: Higher arterial stiffness decreases the initial ventricular power and increases RV systolic pressure in MR.

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