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Heart rate dependency of pulse pressure amplification and arterial stiffness
Ian B Wilkinson1, Nadia Haj Mohammad, Sian Tyrrell
1Clinical Pharmacology Unit, University of Edinburgh, Western General Hospital, United Kingdom. ibw20@cam.ac.uk
Insights
Peripheral pulse pressure is not a reliable indicator of central hemodynamic changes with heart rate variations. Arterial stiffness, measured by pulse wave velocity, remains unaffected by acute heart rate changes in healthy individuals.
Area of Science:
- Cardiovascular physiology
- Hemodynamics
- Arterial stiffness assessment
Background:
- Pulse pressure and aortic pulse wave velocity are key cardiovascular risk factors.
- Peripheral pulse pressure may not accurately reflect central pressure or arterial stiffness.
- Investigating heart rate's acute effects on arterial stiffness is crucial.
Purpose of the Study:
- To evaluate the impact of acute heart rate alterations on arterial stiffness.
- To assess changes in peripheral and central pulse pressure during heart rate manipulation.
- To determine if heart rate influences central hemodynamics and arterial stiffness.
Main Methods:
- Twenty healthy subjects (20-72 years) underwent cardiac catheterization.
- Pulse wave analysis was employed to measure central pressure and augmentation index (AIx).
- Aortic pulse wave velocity (PWV) was determined during right atrial pacing (80-120 bpm).
Main Results:
- Pulse pressure amplification rose with pacing due to decreased central pressure augmentation.
- Augmentation index (AIx) showed a significant inverse correlation with heart rate (r = -0.70, P < .001).
- Pulse wave velocity (PWV) remained unchanged, indicating no alteration in arterial stiffness.
Conclusions:
- Peripheral pulse pressure is an inaccurate measure of central hemodynamic shifts related to heart rate changes.
- Acute heart rate variations do not affect aortic stiffness in healthy subjects.
- Augmentation index changes reflect altered wave reflection timing, not arterial stiffness modifications.
Background:
Pulse pressure and aortic pulse wave velocity, measures of arterial stiffness, are both important determinants of cardiovascular risk. However, assessment of peripheral pulse pressure does not always provide a reliable measure of changes in central pulse pressure or arterial stiffness. The aim of the present study was to assess the effect of acute changes in heart rate on arterial stiffness and on peripheral and central pulse pressure in healthy subjects.
Methods:
Twenty subjects (age range, 20 to 72 years) were studied at cardiac catheterization. Pulse wave analysis was used to determine central pressure, augmentation index (AIx), a measure of systemic arterial stiffness, and aortic pulse wave velocity (PWV) during right atrial pacing (80 to 120 beats/min).
Results:
Pulse pressure amplification increased during pacing due to a reduction in central pressure augmentation. AIx was significantly and inversely related to heart rate (r = -0.70, P < .001) due to an alteration in the relative timing of the reflected pressure wave, rather than a reduction in arterial stiffness, as PWV did not change.
Conclusions:
These data suggest that peripheral pulse pressure does not provide an accurate assessment of changes in central hemodynamics in relation to changes in heart rate, and that aortic stiffness is not affected by acute changes in heart rate.