Confounding effects of heart rate on pulse wave velocity in paced patients with a low degree of atherosclerosis.

Abstract

These results demonstrate that even in patients with a low degree of atherosclerosis, HR is a potential modulator of carotid-femoral PWV.

Recommendations for Improving and Standardizing Vascular Research on Arterial Stiffness

“…The relationship between heart rate and arterial stiffness is less well defined, with acute studies showing positive associations (16;309;310), no association (311;312), or even inverse associations (313) between increased heart rate and various measures of arterial stiffness, including pulse wave velocity. These disparate results reflect that at least some of the studies may have been confounded by concomitant changes in MAP.…”

Acute Tachycardia Increases Aortic Distensibility, but Reduces Total Arterial Compliance Up to a Moderate Heart Rate

“…Liang et al found a significant increase of MAP and aortic PWV as patient's HR changed from 56 to 80 bpm, but no significant difference as HR increased from 80 to 100 bpm (Liang et al, 1999 ). Haesler et al and Lantelme et al showed constant MAP and increased PWV in elevated HR (the highest HR was below 100 bpm) in patients with a low degree of atherosclerosis (Haesler et al, 2004 ) and in subjects with a mean age of 77.8 ± 8.4 years (Lantelme et al, 2002 ), respectively. The increase of PWV by rapid pacing is not in agreement with the findings in Table 2 (normal swine), which may be attributed to aortic diseases such as atherosclerosis (Haesler et al, 2004 ) and old age (Lantelme et al, 2002 ) in those patients, or the role of activation of adrenergic system in physiological HR (from 56 to 80 bpm) in young patients not treated with sedative drugs (Liang et al, 1999 ).…”

“…The variation of characteristic impedance (Z c in Equation 2) in descending aorta was consistent with the measured aortic PWV given Z c ∞PWV (Huo and Kassab, 2006 ). Clinical studies have investigated the relationship between acute tachycardia and aortic PWV, which have led to contradictory results such as: unchanged PWV (Wilkinson et al, 2000 ; Albaladejo et al, 2001 ), decreased PWV (Stefanadis et al, 1998 ), or increased PWV (Liang et al, 1999 ; Lantelme et al, 2002 ; Haesler et al, 2004 ). Liang et al found a significant increase of MAP and aortic PWV as patient's HR changed from 56 to 80 bpm, but no significant difference as HR increased from 80 to 100 bpm (Liang et al, 1999 ).…”

“…The pathophysiology of elevated HR for cardiovascular disease is potentially involved in the decrease of arterial distensibility because a long-term elevated arterial stiffness can be an important determinant of the development and progression of hypertension (Stefanadis et al, 1998 ; O'Rourke and Hashimoto, 2007 ; Fox and Ferrari, 2011 ; Safar, 2018 ). There is also debate on the mechanical response of large conduit arteries to acute tachycardia (Stefanadis et al, 1998 ; Liang et al, 1999 ; Wilkinson et al, 2000 ; Albaladejo et al, 2001 ; Lantelme et al, 2002 ; Haesler et al, 2004 ) and lack of studies on the mechanical response of small arteries to heart rate changes. Based on the in vivo and ex vivo measurements, the second objective of this study is to investigate the effects of rapid pacing on arterial distensibility in aorta and small arteries of normotensive swine, which can enhance the understanding of arterial stiffness relevant to elevated HR.…”

Modeling Arterial Pulse Pressure From Heart Rate During Sympathetic Activation by Progressive Central Hypovolemia

“…The duration of the cardiac cycle determines the length of diastole and influences the shape of the arterial pressure waveform (Wilkinson et al, 2000 ; Lantelme et al, 2002 ; Albaladejo et al, 2004 ; Haesler et al, 2004 ; Westerhof et al, 2008 ; Mackenzie et al, 2009 ; Benetos et al, 2010 ; Westerhof and Westerhof, 2013 ; Rimoldi et al, 2016 ). Recently, studies in both animals and humans using pacing or a selective negative chronotropic agent alleged evidence for an inverse relationship between PP and heart rate (HR) (Lantelme et al, 2002 ; Albaladejo et al, 2004 ; Haesler et al, 2004 ; Rimoldi et al, 2016 ). A lower HR prolongates diastole more than systole, widening PP (Figure 1 ; Folkow and Ely, 1998 ).…”