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Left ventricular ejection time, not heart rate, is an independent correlate of aortic pulse wave velocity
Paolo Salvi1, Carlo Palombo, Giovanni Matteo Salvi
1Department of Cardiology, San Luca Hospital, IRCCS Istituto Auxologico Italiano, Milan, Italy;
Insights
Pulse wave velocity, a marker of arterial stiffness, is more closely linked to left ventricular systolic function than heart period across all ages. This finding has implications for understanding cardiovascular health and disease progression.
Area of Science:
- Cardiovascular Physiology
- Biomedical Engineering
- Arterial Biomechanics
Background:
- Pulse wave velocity (PWV) is a key indicator of arterial stiffness and cardiovascular risk.
- Previous research suggests a link between heart rate and PWV, but the influence of specific cardiac cycle components remains unclear.
- Large-scale studies are needed to clarify the relationship between PWV and temporal aspects of the cardiac cycle.
Purpose of the Study:
- To investigate the association between carotid-femoral pulse wave velocity (cf-PWV) and heart period, left ventricular ejection time (LVET), and diastolic time in a large, diverse age group.
- To determine which cardiac cycle components are the primary determinants of cf-PWV.
- To explore potential age-related differences in these relationships.
Main Methods:
- Carotid-femoral pulse wave velocity (cf-PWV) was measured in 3,020 untreated individuals.
- Carotid pulse wave analysis using high-fidelity applanation tonometry was employed to determine heart period, left ventricular ejection time (LVET), diastolic time, and early-systolic dP/dt.
- Statistical analyses, including correlation and multiple stepwise regression, were performed to assess relationships between variables.
Main Results:
- A significant inverse association was observed between cf-PWV and LVET across all age groups.
- A weaker, significant negative correlation was found between cf-PWV and heart period, except in the youngest subjects.
- cf-PWV showed a significant positive correlation with early-systolic dP/dt.
- Multiple regression analysis identified LVET and dP/dt as the sole significant determinants of cf-PWV, independent of age.
Conclusions:
- Left ventricular systolic function, as reflected by LVET and dP/dt, is a more critical determinant of pulse wave velocity than heart period.
- These findings suggest that PWV assessment may offer insights into left ventricular performance beyond its role as a measure of arterial stiffness.
- The results have potential methodological and pathophysiological implications for cardiovascular research and clinical practice.
Abstract:
Several studies showed a positive association between heart rate and pulse wave velocity, a sensitive marker of arterial stiffness. However, no study involving a large population has specifically addressed the dependence of pulse wave velocity on different components of the cardiac cycle. The aim of this study was to explore in subjects of different age the link between pulse wave velocity with heart period (the reciprocal of heart rate) and the temporal components of the cardiac cycle such as left ventricular ejection time and diastolic time. Carotid-femoral pulse wave velocity was assessed in 3,020 untreated subjects (1,107 men). Heart period, left ventricular ejection time, diastolic time, and early-systolic dP/dt were determined by carotid pulse wave analysis with high-fidelity applanation tonometry. An inverse association was found between pulse wave velocity and left ventricular ejection time at all ages (<25 years, r(2) = 0.043; 25-44 years, r(2) = 0.103; 45-64 years, r(2) = 0.079; 65-84 years, r(2) = 0.044; ≥ 85 years, r(2) = 0.022; P < 0.0001 for all). A significant (P < 0.0001) negative but always weaker correlation between pulse wave velocity and heart period was also found, with the exception of the youngest subjects (P = 0.20). A significant positive correlation was also found between pulse wave velocity and dP/dt (P < 0.0001). With multiple stepwise regression analysis, left ventricular ejection time and dP/dt remained the only determinant of pulse wave velocity at all ages, whereas the contribution of heart period no longer became significant. Our data demonstrate that pulse wave velocity is more closely related to left ventricular systolic function than to heart period. This may have methodological and pathophysiological implications.
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