期刊
CIRCULATION-HEART FAILURE
卷 6, 期 6, 页码 1165-1171出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1161/CIRCHEARTFAILURE.113.000481
关键词
diet; heart failure; diastolic; preserved left ventricular function; salt-sensitivity hypertension; ventricular; vascular coupling hemodynamics
资金
- National Institutes of Health [K23HL109176, UL1TR000433]
- Innovations in Cardiovascular Medicine Award from the University of Michigan Cardiovascular Center
- Alan A. and Edith L. Wolff Charitable Trust (St. Louis, MO)
- Barnes-Jewish Hospital Foundation
- Heartland Affiliate predoctoral fellowship award from the American Heart Association [11PRE4950009]
- Honorary Scholars Summer Research Grant from Washington University in St. Louis
Background Heart failure with preserved ejection fraction (HFPEF) involves failure of cardiovascular reserve in multiple domains. In HFPEF animal models, dietary sodium restriction improves ventricular and vascular stiffness and function. We hypothesized that the sodium-restricted dietary approaches to stop hypertension diet (DASH/SRD) would improve left ventricular diastolic function, arterial elastance, and ventricular-arterial coupling in hypertensive HFPEF. Methods and Results Thirteen patients with treated hypertension and compensated HFPEF consumed the DASH/SRD (target sodium, 50 mmol/2100 kcal) for 21 days. We measured baseline and post-DASH/SRD brachial and central blood pressure (via radial arterial tonometry) and cardiovascular function with echocardiographic measures (all previously invasively validated). Diastolic function was quantified via the parametrized diastolic filling formalism that yields relaxation/viscoelastic (c) and passive/stiffness (k) constants through the analysis of Doppler mitral inflow velocity (E-wave) contours. Effective arterial elastance (E-a) end-systolic elastance (E-es) and ventricular-arterial coupling (defined as the ratio E-es:E-a) were determined using previously published techniques. Wilcoxon matched-pairs signed-rank tests were used for pre-post comparisons. The DASH/SRD reduced clinic and 24-hour brachial systolic pressure (15535 to 13830 and 130 +/- 16 to 123 +/- 18 mm Hg; both P=0.02), and central end-systolic pressure trended lower (116 +/- 18 to 111 +/- 16 mm Hg; P=0.12). In conjunction, diastolic function improved (c=24.3 +/- 5.3 to 22.7 +/- 8.1 g/s; P=0.03; k=252 +/- 115 to 170 +/- 37 g/s(2); P=0.03), E-a decreased (2.0 +/- 0.4 to 1.7 +/- 0.4 mm Hg/mL; P=0.007), and ventricular-arterial coupling improved (E-es:E-a=1.5 +/- 0.3 to 1.7 +/- 0.4; P=0.04). Conclusions In patients with hypertensive HFPEF, the sodium-restricted DASH diet was associated with favorable changes in ventricular diastolic function, arterial elastance, and ventricular-arterial coupling. Clinical Trial Registration URL: http://www.clinicaltrials.gov. Unique identifier: NCT00939640.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据