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ABSTRACT: Objectives
The aim of this study was to evaluate racial differences in arterial elastance (Ea), which reflects the arterial afterload faced by the left ventricle, and its associations with cardiac structure and function. The hypothesis under study was that the left ventricle in blacks displays heightened afterload sensitivity compared with whites.Background
Chronic increasing in arterial afterload may be an important trigger for left ventricular (LV) remodeling and dysfunction that lead to heart failure. Racial differences in the predisposition to heart failure are well described, but the underlying mechanisms remain unclear.Methods
In total, 5,727 community-based, older ARIC (Atherosclerosis Risk In Community) study participants (22% black) who underwent echocardiography between 2011 and 2013 were studied.Results
Blacks were younger (mean age 75 ± 5 years vs. 76 ± 5 years), were more frequently female (66% vs. 57%), and had higher prevalence rates of obesity (46% vs. 31%), hypertension (94% vs. 80%), and diabetes mellitus (47% vs. 34%) than whites. Adjusting for these baseline differences, Ea was higher among blacks (1.96 ± 0.01 mm Hg/ml vs. 1.80 ± 0.01 mm Hg/ml). In blacks, Ea was associated with greater LV remodeling (LV mass index, β = 3.21 ± 0.55 g/m2, p < 0.001) and higher LV filling pressures (E/e' ratio, β = 0.42 ± 0.11, p < 0.001). These relationships were not observed in whites (LV mass, β = 0.16 ± 0.32 g/m2, p = 0.61, p for interaction <0.001; E/e' ratio, β = -0.32 ± 0.06, p < 0.001, p for interaction <0.001).Conclusions
These community-based data suggest that black Americans display heightened afterload sensitivity as a stimulus for LV structural and functional remodeling, which may contribute to their greater risk for heart failure compared with white Americans.
SUBMITTER: Fernandes-Silva MM
PROVIDER: S-EPMC5336438 | biostudies-literature | 2017 Mar
REPOSITORIES: biostudies-literature
Fernandes-Silva Miguel M MM Shah Amil M AM Hegde Sheila S Goncalves Alexandra A Claggett Brian B Cheng Susan S Nadruz Wilson W Kitzman Dalane W DW Konety Suma H SH Matsushita Kunihiro K Mosley Thomas T Lam Carolyn S P CS Borlaug Barry A BA Solomon Scott D SD
JACC. Heart failure 20161221 3
<h4>Objectives</h4>The aim of this study was to evaluate racial differences in arterial elastance (Ea), which reflects the arterial afterload faced by the left ventricle, and its associations with cardiac structure and function. The hypothesis under study was that the left ventricle in blacks displays heightened afterload sensitivity compared with whites.<h4>Background</h4>Chronic increasing in arterial afterload may be an important trigger for left ventricular (LV) remodeling and dysfunction th ...[more]