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La stiffness vascolareF. Antonini-Canterin (Sacile - Pordenone)
La stiffness vascolare
“Le penseur”August Rodin, 1902
- What?- How?- Why?
1. Arterial stiffness
Stiffness arteriosa: cos’è?
Windkessel model: the arterial system is compared to a fire-hose system.
Proximal part:
CUSHIONING FUNCTION
(more elastic arteries)
Periphery:
CONDUIT FUNCTION
(stiffer arteries)
Proximal and distal arteries
More elastic Stiffer
The higher the arterial stiffness, the higher the speed of travel of forward and retrograde waves.
Lower PWVLower PP
Higher PWVHigher PP
Propagative model: the arterial system is compared to a tree in winter
Forward wave Backward wave
Propagative model
From arteries to heart…
In young (with elastic arteries) the pulsewave reflection arrives in diastole and thecoronary perfusion is augmented.
In elderly (with stiff arteries) the speedof travel of pulse wave is higher and thereflection wave is premature in latesystole, increasing central PP and SBP;SBP increases the load on the LV, leadingto ventricular hypertrophy and increasedmyocardial oxigen demand.
2. Arterial stiffness
Arterial stiffness
PWV - MRI
Augmentation index
CAROTID ECHOTRACKING
CAROTID QAS
A simple echo method to estimate systemic arterial compliance
Hypertension 1999; 33;800
Systemic stiffness
JACC 2005; 46: 291SAC is calculated as the ratio of stroke volume index to arterial pulse pressure
3. Arterial stiffness
Arterial stiffness: clinical applications
Circulation 2006;113:664
1678 subjects (sex- and age-stratified random sample of the general Danish population
Circulation 2006;113:657
2835 apparently healthy subjects
Clin Med Research 2007;1:45
PWV RR
Role of Serum Uric Acid Levels on local carotid arterial stiffness and
intima-media thickness: a high resolution echo-tracking study.
Francesco Antonini-Canterin, Giulio Prati, Stefano Poli, Marco Pellegrinet, Olga Vriz, Salvatore
La Carrubba, Vitantonio Di Bello, Scipione Carerj, Concetta Zito, Daniela Pavan, Anca
Mateescu, Carmen Ginghina, Bogdan A. Popescu, Gian Luigi Nicolosi
Group 1: no RFGroup 2: 1 RFGroup 3: ≥ 2 RF
La prevenzione è sempre appropriata!
