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Non-invasive Systemic Hemodynamic Index in Vascular Risk Stratification Tailored for Hypertensives
Vascular dysfunction is a key hallmark of hypertension and related cardiovascular outcomes. As a well-known hemodynamic disease, hypertension is characterized by abnormal ventricular-vascular interactions. Complementing non-invasive systemic hemodynamics in hypertensive vascular risk assessment is o...
Autores principales: | , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8645861/ https://www.ncbi.nlm.nih.gov/pubmed/34881303 http://dx.doi.org/10.3389/fcvm.2021.744349 |
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author | Zhang, Jianning Liang, Jiawen Zhang, Xiaoyu Su, Chen He, Jiang Qiu, Yumin Zhou, Zhe Wang, Zhichao Dong, Bing Tu, Qiang Xu, Shiyue Xia, Wenhao Tao, Jun |
author_facet | Zhang, Jianning Liang, Jiawen Zhang, Xiaoyu Su, Chen He, Jiang Qiu, Yumin Zhou, Zhe Wang, Zhichao Dong, Bing Tu, Qiang Xu, Shiyue Xia, Wenhao Tao, Jun |
author_sort | Zhang, Jianning |
collection | PubMed |
description | Vascular dysfunction is a key hallmark of hypertension and related cardiovascular outcomes. As a well-known hemodynamic disease, hypertension is characterized by abnormal ventricular-vascular interactions. Complementing non-invasive systemic hemodynamics in hypertensive vascular risk assessment is of promising significance. We aimed to investigate the effects of abnormal hemodynamic states other than elevated blood pressure on vascular damage and establish a united index of systemic hemodynamics for generalized vascular risk evaluation. Non-invasive systemic hemodynamics, assessed by impedance cardiography, was compared among blood pressure stages. Vascular function was evaluated by flow-mediated dilation (FMD) and brachial-ankle pulse wave velocity (baPWV). Systemic hemodynamics was obtained from a total of 88 enrollees with a mean (±SD) systolic blood pressure 140 (±17) mm Hg, and aged 17 to 91 years. Both stroke systemic vascular resistance index and left stroke work index exhibited a significant alteration among blood pressure stages (p < 0.001; p = 0.01, respectively), whereas heterogeneous hemodynamic and vascular function subsets existed within similar blood pressure. In addition, blood pressure categories failed to recognize between-group differences in endothelial dysfunction (p = 0.88) and arterial stiffness (p = 0.26). An increase in myocardial contractility and a parallel decrease in afterload was associated with the decline of vascular dysfunction. Systemic Hemodynamic Index (SHI), as a surrogate marker, demonstrated a significantly negative correlation with vascular damage index (VDI, r = −0.49, p < 0.001). These findings illustrate that systemic hemodynamics underlying hypertensives provides more vascular information. The SHI/VDI score may be a feasible tool for cardiovascular function assessment. |
format | Online Article Text |
id | pubmed-8645861 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-86458612021-12-07 Non-invasive Systemic Hemodynamic Index in Vascular Risk Stratification Tailored for Hypertensives Zhang, Jianning Liang, Jiawen Zhang, Xiaoyu Su, Chen He, Jiang Qiu, Yumin Zhou, Zhe Wang, Zhichao Dong, Bing Tu, Qiang Xu, Shiyue Xia, Wenhao Tao, Jun Front Cardiovasc Med Cardiovascular Medicine Vascular dysfunction is a key hallmark of hypertension and related cardiovascular outcomes. As a well-known hemodynamic disease, hypertension is characterized by abnormal ventricular-vascular interactions. Complementing non-invasive systemic hemodynamics in hypertensive vascular risk assessment is of promising significance. We aimed to investigate the effects of abnormal hemodynamic states other than elevated blood pressure on vascular damage and establish a united index of systemic hemodynamics for generalized vascular risk evaluation. Non-invasive systemic hemodynamics, assessed by impedance cardiography, was compared among blood pressure stages. Vascular function was evaluated by flow-mediated dilation (FMD) and brachial-ankle pulse wave velocity (baPWV). Systemic hemodynamics was obtained from a total of 88 enrollees with a mean (±SD) systolic blood pressure 140 (±17) mm Hg, and aged 17 to 91 years. Both stroke systemic vascular resistance index and left stroke work index exhibited a significant alteration among blood pressure stages (p < 0.001; p = 0.01, respectively), whereas heterogeneous hemodynamic and vascular function subsets existed within similar blood pressure. In addition, blood pressure categories failed to recognize between-group differences in endothelial dysfunction (p = 0.88) and arterial stiffness (p = 0.26). An increase in myocardial contractility and a parallel decrease in afterload was associated with the decline of vascular dysfunction. Systemic Hemodynamic Index (SHI), as a surrogate marker, demonstrated a significantly negative correlation with vascular damage index (VDI, r = −0.49, p < 0.001). These findings illustrate that systemic hemodynamics underlying hypertensives provides more vascular information. The SHI/VDI score may be a feasible tool for cardiovascular function assessment. Frontiers Media S.A. 2021-11-22 /pmc/articles/PMC8645861/ /pubmed/34881303 http://dx.doi.org/10.3389/fcvm.2021.744349 Text en Copyright © 2021 Zhang, Liang, Zhang, Su, He, Qiu, Zhou, Wang, Dong, Tu, Xu, Xia and Tao. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Cardiovascular Medicine Zhang, Jianning Liang, Jiawen Zhang, Xiaoyu Su, Chen He, Jiang Qiu, Yumin Zhou, Zhe Wang, Zhichao Dong, Bing Tu, Qiang Xu, Shiyue Xia, Wenhao Tao, Jun Non-invasive Systemic Hemodynamic Index in Vascular Risk Stratification Tailored for Hypertensives |
title | Non-invasive Systemic Hemodynamic Index in Vascular Risk Stratification Tailored for Hypertensives |
title_full | Non-invasive Systemic Hemodynamic Index in Vascular Risk Stratification Tailored for Hypertensives |
title_fullStr | Non-invasive Systemic Hemodynamic Index in Vascular Risk Stratification Tailored for Hypertensives |
title_full_unstemmed | Non-invasive Systemic Hemodynamic Index in Vascular Risk Stratification Tailored for Hypertensives |
title_short | Non-invasive Systemic Hemodynamic Index in Vascular Risk Stratification Tailored for Hypertensives |
title_sort | non-invasive systemic hemodynamic index in vascular risk stratification tailored for hypertensives |
topic | Cardiovascular Medicine |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8645861/ https://www.ncbi.nlm.nih.gov/pubmed/34881303 http://dx.doi.org/10.3389/fcvm.2021.744349 |
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