Abstract
Diastolic dysfunction and arterial stiffness: the chicken or the egg
Highlights
Several years after their first publication on ventricular stress in the late 1960s, when they linked high gradients of stress in both the endocardial layers and in the arterial vessel wall, Mirsky et al concluded already in 1973: ‘High gradients of stress are due to the fact that the elastic stiffness of the wall material increases with the stress which reaches maximum levels in the endocardial layers
Arterial stiffness increases with age, cardiometabolic abnormalities, and increased sodium intake, all of which are associated with heart failure [4]
Arterial stiffness by itself is associated with left ventricular diastolic dysfunction [5,6,7]
Summary
Several years after their first publication on ventricular stress in the late 1960s, when they linked high gradients of stress in both the endocardial layers and in the arterial vessel wall, Mirsky et al concluded already in 1973: ‘High gradients of stress are due to the fact that the elastic stiffness of the wall material increases with the stress which reaches maximum levels in the endocardial layers. Arterial stiffening results in a widening of the arterial pulse pressure and local increases in shear stress, which is associated with endothelial dysfunction and vascular disease [2, 3]. Arterial stiffness by itself is associated with left ventricular diastolic dysfunction [5,6,7].
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