The Association of Systemic Vascular Disease with Right Ventricular Morphology: The MESA-Right Ventricle Study.
vascular stiffness is recognized as one of the major contributors to the development of
left ventricular (LV) diastolic dysfunction and heart failure; however little is known
about the relationship of systemic vascular stiffness and the right ventricle (RV).
Using data from the Multi-Ethnic Study of Atherosclerosis, we explored the association
between systemic vascular ... read morestiffness measures (total arterial compliance (TAC), systemic
vascular resistance (SVR), aortic augmentation index and reflection magnitude) and the
RV morphology (RV mass, RV end-systolic volume, RV end-diastolic volume and RV ejection
fraction). All analyses were adjusted for allometric, demographic and clinical variables
as well as the corresponding LV parameter. A total of 3,842 subjects without clinical
cardiovascular disease who had complete data on the systemic vascular measures and the
RV measures were included in the analysis. The mean age of the study sample was 61
± 10 years with 48% males, 39% non-Hispanic white, 25% Chinese-American, 23%
Hispanic, and 13% African American participants. Lower TAC and higher SVR were
significantly associated with lower RV mass and smaller RV volumes in fully adjusted
models. A 1 mL/mmHg increase in TAC was associated with a 2.4 grams greater RV mass, a
3.9 mL larger RVESV and a 7.6 mL larger RVEDV. A 5 Wood unit increase in SVR was
associated with a 1.8 grams smaller RV mass, a 4.9 mL smaller RVESV and a 12.3 mL
smaller RVEDV. We also found significant effect modification by age and sex for TAC with
RV mass and volumes. Similarly, we found significant effect modification by race and age
for SVR with RV mass and volumes. Higher aortic augmentation index and reflection
magnitude were associated with smaller RV end-diastolic volume. A 1% increase in aortic
augmentation index was associated with a 0.2 mL smaller RVEDV and a 1 unit increase in
RM was associated with a 10.1 mL smaller RVEDV. We also found significant effect
modification by age and sex for aortic augmentation index with RVEDV. Increased systemic
vascular stiffness was associated with lower RV mass and smaller RV volumes in a
population of adults without clinical cardiovascular disease. Whether therapies that
target systemic vascular stiffness can also impact the RV morphology remains to be
Thesis (M.S.)--Tufts University, 2016.
Submitted to the Dept. of Clinical & Translational Science.
Advisor: Jessica Paulus.
Committee: Kari Roberts, and Robin Ruthazer.
Keyword: Medicine.read less