Arterial Function and Arterial-Ventricular Interaction

The Cardiovascular Biomarkers Lab has investigated factors that influence arterial function and the effect of arterial function on ventricular function.

Several of these studies were conducted in a well-characterized, community-based cohort of siblings with hypertension enrolled in the Genetic Epidemiology Network of Arteriopathy (GENOA) study.

Participants undergo a comprehensive vascular assessment that includes:

  • Systolic pulse contour analysis (central systolic blood pressure, diastolic blood pressure, pulse pressure, forward wave amplitude, reflected wave amplitude and augmentation index)
  • Aortic characteristic impedance (Zc)
  • Pulse wave velocity (carotid-femoral and carotid-radial)
  • Compliance calculations (including proximal and total aortic compliance)
  • Endothelial function (evaluated by measuring brachial artery reactivity using vascular ultrasound)
  • Left ventricular function (assessed by transthoracic echocardiography)

Arterial stiffness, especially in the proximal part of the aorta, is the main determinant of left ventricular afterload.

Our research team in the Cardiovascular Biomarkers Lab used speckle tracking echocardiography, arterial tonometry and arterial load-analysis software to assess:

  • Association of arterial load with LV function
  • Impact of progression of aortic stiffness on subclinical atherosclerosis

Our lab team also is assessing the association of a measure of arterial stiffness called cardio-ankle vascular index (CAVI) with LV function and structure.

The measure is based on the Bramwell-Hill's equation and is derived using cuff-measured blood pressure readings in the extremities after accounting for the difference in time domain from central aorta to periphery. This study includes 600 patients for transthoracic echocardiography examination, with CAVI measured on the day of echocardiography.

Related publications

  • Coutinho T, Pellikka PA, Bailey KR, Turner ST, Kullo IJ. Sex differences in the associations of hemodynamic load with left ventricular hypertrophy and concentric remodeling. Am J Hypertens. 2016 Jan;29(1):73-80. doi: 10.1093/ajh/hpv071. Epub 2015 Jun 1. [PMID: 26031305].
  • Ye Z, Coutinho T, Pellikka PA, Villarraga HR, Borlaug BA, Kullo IJ. Associations of alterations in pulsatile arterial load with left ventricular longitudinal strain. Am J Hypertens. 2015 Nov;28(11):1325-31. doi:10.1093/ajh/hpv039. Epub 2015 Apr 3. [PMID: 25840581; PMC4715245].
  • Coutinho T, Bailey KR, Turner ST, Kullo IJ. Arterial stiffness is associated with increase in blood pressure over time in treated hypertensives. J Am Soc Hypertens. 2014 Jun;8(6):414-21. doi: 10.1016/j.jash.2014.03.330. Epub 2014 Apr 4. [PMID: 24952654; PubMed Central PMCID: PMC4103613].
  • Coutinho T, Borlaug BA, Pellikka PA, Turner ST, Kullo IJ. Sex differences in arterial stiffness and ventricular-arterial interactions. Am Coll Cardiol. 2013 Jan 8;61(1):96-103. doi: 10.1016/j.jacc.2012.08.997. Epub 2012 Nov 1. Erratum in: J Am Coll Cardiol. 2013 Jun 25;61(25):2573-4. [PMID: 23122799; PubMed Central PMCID: PMC3773521].
  • Ye Z, Coutinho T, Kullo I. Ankle-brachial index predicts progression of aortic stiffness. Circulation. 2014;130:Suppl 2 A17983.
  • Ye Z, Coutinho T, Pellikka PA, Villarraga HR, Borlaug BA, Kullo IJ. Measures of pulsatile arterial load are associated with myocardial wall stress during systole [Oral presentation in 2013 ACC scientific session]. Journal of the American College of Cardiology 2014, Volume 63, Issue 12, Supplement, A2036.
  • Zi Y, Borlaug BA, Pellikka PA, Coutinho T, Villarraga HR, Kullo IJ. A higher waist-hip ratio is associated with greater aortic stiffness and worse left ventricular deformation [Modulated Poster presentation in 2014 ASE] 2014 American Society of Echocardiography Scientific Session, Portland, Oregon.
  • Ye Z, Coutinho T, Pellikka PA, Villarraga HR, Borlaug BA, Kullo IJ. Measures of pulsatile arterial load are associated with myocardial wall stress during systole [Oral presentation in 2013 ACC scientific session]. Journal of the American College of Cardiology 2014, Volume 63, Issue 12, Supplement, A2036.
  • Ye Z, Smith C, Pellikka PA, Borlaug BA, Kullo IJ. Ventricular-arterial coupling is altered in patients with peripheral arterial disease and associated with mortality [Poster presentation in 2013 AHA scientific session]. Circulation. 2013;128:22 Supplement A17624.
  • Coutinho T, Ye Z, Pellikka PA, Borlaug BA, Khan MB, Villarraga HR, Kullo IJ. Proximal aortic stiffness and pulsatile hemodynamic load are associated with impaired left ventricular longitudinal deformation in patients with preserved ejection fraction. Circulation. 2012;126:21 Supplement A14588.