Carotid arterial compliance in patients with congestive heart failure secondary to idiopathic dilated cardiomyopathy.

S G Lage, L Kopel, M C Monachini, C J Medeiros, F Pileggi, J F Polak, M A Creager
Author Information
  1. S G Lage: Heart Institute, School of Medicine, University of São Paulo, Brazil.

Abstract

Conduit artery distensibility affects the pulsatile component of afterload and may contribute to impaired left ventricular function in patients with congestive heart failure (CHF). The objectives of this study were to (1) determine whether arterial distensibility is reduced in patients with CHF, and (2) determine whether decreased arterial compliance is related to an abnormality in vascular wall structure (i.e., wall thickness or excessive levels of circulating neurohumoral vasoconstrictors, or both). The study participants included 40 patients with CHF secondary to idiopathic dilated cardiomyopathy and 33 age-matched healthy volunteers. High-resolution ultrasonography was performed to directly visualize the common carotid artery and measure its diameter and wall thickness. Its elastic properties were determined by relating changes in arterial diameter to changes in pressure generated with each heart beat. Carotid artery distensibility was less (14.1 +/- 1.1 vs 25.3 +/- 1.6 10(-6).N-1.m2, p < 0.001) and Young's modulus of elasticity was greater (3.99 +/- 0.51 vs 2.29 +/- 0.23 10(5).N.m-2, p < 0.005) in patients with CHF than in normal subjects. Also, carotid artery wall thickness was increased in patients with CHF. When the entire population was considered, age, wall thickness, and plasma norepinephrine and aldosterone concentrations correlated inversely with distensibility, whereas age and plasma norepinephrine concentration correlated directly with elasticity. Among normal subjects, only age correlated inversely with distensibility; among patients with CHF, only plasma norepinephrine concentration correlated with elasticity. It is concluded that carotid artery distensibility is reduced in patients with CHF.(ABSTRACT TRUNCATED AT 250 WORDS)

Grants

  1. HL01768/NHLBI NIH HHS
  2. HL02663/NHLBI NIH HHS
  3. HL36348/NHLBI NIH HHS

MeSH Term

Adult
Aged
Aldosterone
Cardiomyopathy, Dilated
Carotid Artery, Common
Compliance
Female
Heart Failure
Humans
Male
Middle Aged
Norepinephrine
Regression Analysis
Ultrasonography

Chemicals

Aldosterone
Norepinephrine

Word Cloud

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