The role of ventricular–arterial coupling in cardiac disease and heart failure: assessment, clinical implications and therapeutic interventions. A consensus document of the European Society of Cardiology Working Group on Aorta & Peripheral Vascular Diseases, European Association of Cardiovascular Imaging, and Heart Failure Association

Ventricular–arterial coupling (VAC) plays a major role in the physiology of cardiac and aortic mechanics, as well as in the pathophysiology of cardiac disease. VAC assessment possesses independent diagnostic and prognostic value and may be used to refine riskstratification and monitor therapeutic in...

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Published in:European journal of heart failure Vol. 21; no. 4; pp. 402 - 424
Main Authors: Ikonomidis, Ignatios, Aboyans, Victor, Blacher, Jacque, Brodmann, Marianne, Brutsaert, Dirk L., Chirinos, Julio A., De Carlo, Marco, Delgado, Victoria, Lancellotti, Patrizio, Lekakis, John, Mohty, Dania, Nihoyannopoulos, Petros, Parissis, John, Rizzoni, Damiano, Ruschitzka, Frank, Seferovic, Petar, Stabile, Eugenio, Tousoulis, Dimitrios, Vinereanu, Dragos, Vlachopoulos, Charalambos, Vlastos, Dimitrios, Xaplanteris, Panagiotis, Zimlichman, Reuven, Metra, Marco
Format: Journal Article
Language:English
Published: Oxford, UK John Wiley & Sons, Ltd 01.04.2019
European Society of Cardiology (Wiley)
Wiley-Blackwell
Subjects:
Arterial elastance
Cardiovascular & respiratory systems
Coronary artery disease
Global longitudinal strain
Heart failure
Human health sciences
Hypertension
Inflammatory disease
Life Sciences
Prognosis
Pulse wave velocity
Santé publique et épidémiologie
Sciences de la santé humaine
Systèmes cardiovasculaire & respiratoire
Treatment
Valvular heart disease
Ventricular elastance
Ventricular-arterial coupling
Heart failure
Hypertension
Valvular heart disease
Arterial elastance
Prognosis
Treatment
Pulse wave velocity
Global longitudinal strain
Ventricular elastance
Coronary artery disease
Ventricular-arterial coupling
Inflammatory disease
ISSN:1388-9842, 1879-0844, 1879-0844
Online Access:Get full text
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Summary:Ventricular–arterial coupling (VAC) plays a major role in the physiology of cardiac and aortic mechanics, as well as in the pathophysiology of cardiac disease. VAC assessment possesses independent diagnostic and prognostic value and may be used to refine riskstratification and monitor therapeutic interventions. Traditionally, VAC is assessed by the non‐invasive measurement of the ratio of arterial (Ea) to ventricular end‐systolic elastance (Ees). With disease progression, both Ea and Ees may become abnormal and the Ea/Ees ratio may approximate its normal values. Therefore, the measurement of each component of this ratio or of novel more sensitive markers of myocardial (e.g. global longitudinal strain) and arterial function (e.g. pulse wave velocity) may better characterize VAC. In valvular heart disease, systemic arterial compliance and valvulo–arterial impedance have an established diagnostic and prognostic value and may monitor the effects of valve replacement on vascular and cardiac function. Treatment guided to improve VAC through improvement of both or each one of its components may delay incidence of heart failure and possibly improve prognosis in heart failure. In this consensus document, we describe the pathophysiology, the methods of assessment as well as the clinical implications of VAC in cardiac diseases and heart failure. Finally, we focus on interventions that may improve VAC and thus modify prognosis.
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scopus-id:2-s2.0-85062878988
ISSN:1388-9842
1879-0844
1879-0844
DOI:10.1002/ejhf.1436