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Atherosclerotic disease of the abdominal aorta and its branches: prognostic implications in patients with heart failure.
- Source :
-
Heart failure reviews [Heart Fail Rev] 2012 Mar; Vol. 17 (2), pp. 229-39. - Publication Year :
- 2012
-
Abstract
- Aortic atherosclerosis reduces compliance in the systemic circulation and increases peripheral resistance, afterload and left ventricular wall stress. In patients with heart failure, these changes can impair left ventricular systolic function and energy efficiency, which could reduce exercise capacity. Though the interaction and the impact of aortic atherosclerosis on left ventricular function have been investigated, its prognostic implications in patients with heart failure are unclear. We used cardiac magnetic resonance imaging and gadolinium-enhanced abdominal aortography to investigate the prevalence and prognostic impact of atherosclerotic disease of the abdominal aorta and its side branches in 355 patients with heart failure. Sclerotic abdominal aortic disease was defined as a luminal narrowing >50% of the aorta and its side branches or the presence of abdominal aortic aneurysm. Patients with disease of the aorta and its branches were older (P < 0.0001), had overall longer stay in hospital (P = 0.006) and had more admissions (P = 0.001) and worse prognosis (hazard ratio: 1.97, 95% confidence interval: 1.29-3.00, P = 0.002) than those without. In a multivariable model, increasing age and pulse pressure, diabetes mellitus and increasing left ventricular end-diastolic volume were associated with a worse prognosis, but sclerotic abdominal aortic disease was not independently related to outcome (hazard ratio: 1.06; 95% confidence interval: 0.64-1.74; P = 0.823). These data demonstrate that atherosclerosis of the abdominal aorta and its side branches is common and associated with increased morbidity in patients with chronic heart failure. How such disease should be managed remains uncertain, but its recognition and characterisation are the first steps in finding out.
- Subjects :
- Aged
Aorta, Abdominal pathology
Aortic Diseases pathology
Atherosclerosis pathology
Female
Follow-Up Studies
Heart physiopathology
Humans
Kaplan-Meier Estimate
Magnetic Resonance Imaging
Male
Middle Aged
Prognosis
Prospective Studies
Aortic Diseases physiopathology
Atherosclerosis physiopathology
Heart Failure physiopathology
Renal Artery Obstruction physiopathology
Ventricular Dysfunction, Left physiopathology
Ventricular Function, Left physiology
Subjects
Details
- Language :
- English
- ISSN :
- 1573-7322
- Volume :
- 17
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Heart failure reviews
- Publication Type :
- Academic Journal
- Accession number :
- 22002211
- Full Text :
- https://doi.org/10.1007/s10741-011-9284-9