Heart rate dependency of pulse pressure amplification and arterial stiffness

Wilkinson, Ian B.; Mohammad, Nadia Haj; Tyrrell, Sian; Hall, Ian Robert; Webb, David J.; Paul, Vince; Levy, Terry; Cockcroft, John R.

doi:10.1016/s0895-7061(01)02252-x

Cited by 322 publications

(241 citation statements)

References 31 publications

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“…[16][17][18] Two recent studies of chronically paced subjects yielded evidence that acute increases in the HR markedly increase CF-PWV 16 and carotid artery distensibility 18 although the existence of this relationship, and its mechanism, remain controversial. 19,20 We also found this independent relationship in the patients with low EF values (Table 4). In healthy young men, a short left ventricular ejection time seems to be a determinant of increased PWV at rest and in conditions of increased sympathetic tone.…”

Section: Discussionsupporting

confidence: 69%

“…PWV is independently associated with cardiovascular morbidity and mortality in patients with hypertension or diabetes, and in the elderly, [10][11][12] whereas AIx is associated with cardiovascular risk factors (CVR) in the general population 13 and with mortality in patients with end-stage renal failure. 14 All these markers are dependent on time domain parameters and on pressure, [15][16][17][18][19][20][21] which may alter their prognostic value in heart failure.…”

Section: Introductionmentioning

confidence: 99%

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Interaction between pulse wave velocity, augmentation index, pulse pressure and left ventricular function in chronic heart failure

Logeart

et al. 2005

J Hum Hypertens

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Pulse wave velocity (PWV), the carotid augmentation index (AIx), and pulse pressure (PP) may be prognostic factors in heart failure, but the possible influence of the ejection fraction (EF) and other simple haemodynamic variables on them has not been investigated in this setting. Noninvasive methods were used to measure carotid-radial (CR), carotid-femoral (CF) PWV and AIx, and brachial PP, in 135 consecutive patients with stable symptomatic chronic heart failure. The patients were divided into two groups, with preserved (X40%) or reduced (o40%) EF. CF-PWV, AIx and PP were lower in the decreased EF group (8.8572.77 versus 10.6072.75 m/s, Po0.001; 121721 versus 132724, P ¼ 0.009 and 41719 versus 67717 mmHg, Po0.001), but CR-PWV values were similar regardless of the EF status. These results were not modified after adjustment for age and sex. Multiple regression analysis showed that AIx and PP were systematically related to time domain parameters (heart rate or ejection duration) and EF, whatever the group. CF-PWV was weakly related to time domain values and unrelated to mean blood pressure (BP) or EF in the preserved EF group, whereas it was related to both mean BP and EF in the low EF group. In conclusion, whatever the EF level, PP and AIx were strongly modulated in the time domain, by pressure and by the EF level. The same relationships were found with CF-PWV, but only in the reduced EF group. Whether CF-PWV is the best prognostic factor in patients with 'diastolic' heart failure must be confirmed in a prospective study.

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Section: Discussionsupporting

confidence: 69%

Section: Introductionmentioning

confidence: 99%

Interaction between pulse wave velocity, augmentation index, pulse pressure and left ventricular function in chronic heart failure

Logeart

et al. 2005

J Hum Hypertens

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“…It must be taken into consideration that AI has a negative correlation with HR (a fall of AI of B5.6% is expected for each 10 beats per min increment in HR). 52 Since the correlation of AI with HR is linear, this phenomenon does not alter the interpretation of our results regarding the difference in responses of AI during the static and dynamic protocols.…”

Section: Lydakis Et Almentioning

confidence: 68%

Changes of central haemodynamic parameters during mental stress and acute bouts of static and dynamic exercise

et al. 2008

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Chronic dynamic (aerobic) exercise decreases central arterial stiffness, whereas chronic resistance exercise evokes the opposite effect. Nevertheless, there is little information available on the effects of acute bouts of exercise. Also, there is limited data showing an increase of central arterial stiffness during acute mental stress. This study aimed to determine the effect of acute mental and physical (static and dynamic exercise) stress on indices of central arterial stiffness. Fifteen young healthy volunteers were studied. The following paradigms were performed: (1) 2 min of mental arithmetic, (2) short bouts (20 s) of static handgrip at 20 and 70% of maximal voluntary contraction (MVC), (3) fatiguing handgrip at 40% MVC and (4) incremental dynamic knee extensor exercise. Central aortic waveforms were assessed using SphygmoCor software. As compared to baseline, pulse wave transit time decreased significantly for all four interventions indicating that central arterial stiffness increased. During fatiguing handgrip there was a fall in the ratio of peripheral to central pulse pressure from 1.69 ± 0.02 at baseline to 1.56±0.05 (Po0.05). In the knee extensor protocol a nonsignificant trend for the opposite effect was noted. The augmentation index increased significantly during the arithmetic, short static and fatiguing handgrip protocols, whereas there was no change in the knee extensor protocol. We conclude that (1) during all types of acute stress tested in this study (including dynamic exercise) estimated central stiffness increased, (2) during static exercise the workload posed on the left ventricle (expressed as change in central pulse pressure) is relatively higher than that posed during dynamic exercise (given the same pulse pressure change in the periphery).

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“…39 Our result, however, demonstrated no significant correlation and is in agreement with other previous studies. [40][41][42] There was also a contradictory study showing reduced aortic stiffness and increased distensibility during incremental pacing. 43 Therefore, in order to clarify the relationship between arterial distensibility and heart rate, and its pathophysiology, further specific studies are necessary.…”

Section: Discussionmentioning

confidence: 99%

Relationship between blood pressure parameters and pulse wave velocity in normotensive and hypertensive subjects: invasive study

et al. 2006

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Blood pressure (BP) is one of the most important contributing factors to pulse wave velocity (PWV), a classic measure of arterial stiffness. Although there have been many non-invasive studies to show the relation between arterial stiffness and BP, the results are controversial. The aim of this study is to evaluate the role of BP as an influencing factor on PWV using invasive method. We observed 174 normotensive and untreated hypertensive subjects using coronary angiography. Arterial stiffness was assessed through aorto-femoral PWV by foot-to-foot velocity method using fluid-filled system. And BP was measured by pressure wave at the right common femoral artery. From univariate analysis, age, diabetes mellitus (DM), hypertension, waist, waist-to-hip ratio, total cholesterol-tohigh-density lipoprotein cholesterol ratio, systolic BP (SBP), pulse pressure (PP) and mean arterial pressure (MAP) showed significant association with PWV. To avoid multiple colinearity among SBP, PP and MAP, we performed multiple regression analysis predicting PWV thrice. Age, DM and each BP were significantly and consistently correlated to PWV. In the first and third modules, compared to age, SBP and MAP were less strong predictors, respectively. However, PP was the stronger predictor than age and DM in the second module. Lastly, we simultaneously forced MAP and PP with other variables in the fourth multivariate analysis. Age, DM and PP remained significantly correlated with PWV, but the significance of MAP was lost. This is the first invasive study to suggest that PP has the strongest correlation with PWV among a variety of BP parameters.

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Heart rate dependency of pulse pressure amplification and arterial stiffness

Cited by 322 publications

References 31 publications

Interaction between pulse wave velocity, augmentation index, pulse pressure and left ventricular function in chronic heart failure

Interaction between pulse wave velocity, augmentation index, pulse pressure and left ventricular function in chronic heart failure

Changes of central haemodynamic parameters during mental stress and acute bouts of static and dynamic exercise

Relationship between blood pressure parameters and pulse wave velocity in normotensive and hypertensive subjects: invasive study

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