Significance of Regional Ventriculo-arterial Coupling in Patients With Chronic Heart Failure
Status:
Unknown status
Trial end date:
1969-12-31
Target enrollment:
Participant gender:
Summary
Heart failure is a major health problem worldwide. Optimal treatment of this disabling and
fatal condition may require functional characterization of the failed left ventricle (LV) and
its interaction with the arterial system. Part of the physiological significance of the
ventriculo-arterial coupling has been studied experimentally and clinically using the
framework of the ratio of effective arterial elastance (Ea) to end-systolic elastance (Ees),
with limited clinical applications.
From central ascending aorta to terminal arterioles, every segment of the arterial tree
contributes to the arterial loads that interact and impact LV performance in both systole and
diastole, leads to atrial and ventricular remodeling and hypertrophy, and results in the
development of heart failure. On the other hand, the ventricular systole is a complex
coordination of multi-directional myocardial fibers involving longitudinal contraction,
circumferential shortening, radial thickening, twist, and torsion, the so-called LV
deformations.
The purposes of the present study are to investigate the relationship between different
components of hemodynamic load or arterial abnormalities and different components of LV
myocardial deformations or regional LV function, the modulating effects of endothelial
progenitor cells (EPCs) on the ventriculo-arterial coupling, and the therapeutic effects of
aliskiren on the components of hemodynamic load and LV myocardial deformations and their
couplings. The investigators will also investigate whether the ventriculo-arterial coupling,
EPCs, and add-on therapy of aliskiren predict cardiovascular outcomes.