Arterial stiffness, macro-vascular, micro-vascular endothelial function and cardiac remodelling in arterial fibrillation

Krishnamoorthy, Suresh (2015). Arterial stiffness, macro-vascular, micro-vascular endothelial function and cardiac remodelling in arterial fibrillation. University of Birmingham. M.D.

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Abstract

In patients with atrial fibrillation (AF) there appears a close link between arterial stiffness, endothelial function and cardiac remodelling thereby contributing to the development and progression of AF as well as to its complications. However this complex interaction(s) is not well understood.

In the \(cross-sectional\) \(study\) with PAF patients, higher arterial stiffness (PP, Pr) is strongly associated with endothelial-dependent macro-vascular dysfunction (Δ%AIx Salbutamol). Similarly a strong relationship observed between arterial stiffness (PP, PWV cf, Pr) and abnormal LA remodelling (LAV and LAD) in PAF patients. Higher levels of vWf and soluble E-Selectin at baseline are independently associated with increased risk of adverse clinical events (including AMI and ischaemic stroke) in ‘\(real\) \(world\)’ AF patients, and may aid clinical risk stratification towards identifying patients at higher risk.

In the \(longitudinal\) \(study\) of dual chamber pacemaker patients there was a close relationship observed between arterial stiffness (PP, PWV cf, Pr), macro-vascular (Δ%AIx Sal) / micro-vascular (∆%LDF Ach) endothelial function and cardiac remodelling (EF, E/A ratio, E\(_M\), A\(_M\)). These findings support the close interaction between ventricular contraction, arterial system and endothelial function towards the development of AF in pacemaker patients, beyond the adverse effects of pacing per se.

Type of Work:

Thesis (Higher Doctorates > M.D.)

Award Type:

Higher Doctorates > M.D.

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