P21 REDUCTION OF CARDIAC PRE-LOAD HAS ANTITHETICAL EFFECTS ON BLOOD PRESSURE AND ARTERIAL STIFFNESS: IS BLOOD PRESSURE THE MAIN DETERMINANT OF WITHIN-SUBJECT VARIATION IN PULSE WAVE VELOCITY?
Objective: Blood pressure (BP) is considered the most important determinant of within-subject variation in pulse wave velocity (PWV) and the possibility of altering arterial stiffness independently of BP is still a matter of debate. When investigating acute effects of a reduction in cardiac pre-load...
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| Format: | Article |
| Language: | English |
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BMC
2017-12-01
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| Series: | Artery Research |
| Online Access: | https://www.atlantis-press.com/article/125930332/view |
| _version_ | 1818006410156310528 |
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| author | Luca Faconti Bushra Farukh Andrii Boguslavskyi Phil Chowienczyk |
| author_facet | Luca Faconti Bushra Farukh Andrii Boguslavskyi Phil Chowienczyk |
| author_sort | Luca Faconti |
| collection | DOAJ |
| description | Objective: Blood pressure (BP) is considered the most important determinant of within-subject variation in pulse wave velocity (PWV) and the possibility of altering arterial stiffness independently of BP is still a matter of debate. When investigating acute effects of a reduction in cardiac pre-load, we hypothesised that this would decrease BP and PWV.
Design and methods: Hypertensive patients (mean±SD age 44±14 years, n = 45) had brachial BP measurements (OMRON), central BP recorded by radial pulse wave analysis (SphygmoCor) and estimation of aortic PWV (aoPWV) by trans-thoracic echocardiography. Carotid-femoral PWV (cfPWV) was also evaluated by SphygmoCor in n = 17. Measurements were performed before and after (>5 minutes) supra-diastolic, sub-systolic pressure inflation of thigh cuffs in order to decrease venous return from the lower limbs. Evaluation of inferior vena cava (IVC) diameter was used to assess pre-load.
Results: Leg cuff-inflation was effective in reducing cardiac pre-load (change in IVC diameter (mean±SE) from 1.6±0.4 cm to 1.3±0.4 cm, p < 0.01) and decreased both brachial and central SBP (−3±0.9 mmHg and −3.6±1.2 mmHg respectively, both p < 0.05) while change in DBP (0.8±0.9 mmHg) and heart rate (−0.1±0.6 bpm) were not significant.
By contrast, aoPWV increased by 0.8±0.35 m/s (p < 0.01) and cfPWV by 1.05±0.33 m/s (p = 0.014).
Conclusions: Contrary to our hypothesis, acute reduction of cardiac pre-load significantly decreased BP but had an opposite effect on PWV. This could be mediated by an increase in sympathetic tone triggered by reduction in circulating blood volume; sympathetic tone might affect PWV independently of BP. |
| first_indexed | 2024-04-14T05:00:50Z |
| format | Article |
| id | doaj.art-8cb2a33c5acf4ce4ab092f3523d4023c |
| institution | Directory Open Access Journal |
| issn | 1876-4401 |
| language | English |
| last_indexed | 2024-04-14T05:00:50Z |
| publishDate | 2017-12-01 |
| publisher | BMC |
| record_format | Article |
| series | Artery Research |
| spelling | doaj.art-8cb2a33c5acf4ce4ab092f3523d4023c2022-12-22T02:10:58ZengBMCArtery Research1876-44012017-12-012010.1016/j.artres.2017.10.162P21 REDUCTION OF CARDIAC PRE-LOAD HAS ANTITHETICAL EFFECTS ON BLOOD PRESSURE AND ARTERIAL STIFFNESS: IS BLOOD PRESSURE THE MAIN DETERMINANT OF WITHIN-SUBJECT VARIATION IN PULSE WAVE VELOCITY?Luca FacontiBushra FarukhAndrii BoguslavskyiPhil ChowienczykObjective: Blood pressure (BP) is considered the most important determinant of within-subject variation in pulse wave velocity (PWV) and the possibility of altering arterial stiffness independently of BP is still a matter of debate. When investigating acute effects of a reduction in cardiac pre-load, we hypothesised that this would decrease BP and PWV. Design and methods: Hypertensive patients (mean±SD age 44±14 years, n = 45) had brachial BP measurements (OMRON), central BP recorded by radial pulse wave analysis (SphygmoCor) and estimation of aortic PWV (aoPWV) by trans-thoracic echocardiography. Carotid-femoral PWV (cfPWV) was also evaluated by SphygmoCor in n = 17. Measurements were performed before and after (>5 minutes) supra-diastolic, sub-systolic pressure inflation of thigh cuffs in order to decrease venous return from the lower limbs. Evaluation of inferior vena cava (IVC) diameter was used to assess pre-load. Results: Leg cuff-inflation was effective in reducing cardiac pre-load (change in IVC diameter (mean±SE) from 1.6±0.4 cm to 1.3±0.4 cm, p < 0.01) and decreased both brachial and central SBP (−3±0.9 mmHg and −3.6±1.2 mmHg respectively, both p < 0.05) while change in DBP (0.8±0.9 mmHg) and heart rate (−0.1±0.6 bpm) were not significant. By contrast, aoPWV increased by 0.8±0.35 m/s (p < 0.01) and cfPWV by 1.05±0.33 m/s (p = 0.014). Conclusions: Contrary to our hypothesis, acute reduction of cardiac pre-load significantly decreased BP but had an opposite effect on PWV. This could be mediated by an increase in sympathetic tone triggered by reduction in circulating blood volume; sympathetic tone might affect PWV independently of BP.https://www.atlantis-press.com/article/125930332/view |
| spellingShingle | Luca Faconti Bushra Farukh Andrii Boguslavskyi Phil Chowienczyk P21 REDUCTION OF CARDIAC PRE-LOAD HAS ANTITHETICAL EFFECTS ON BLOOD PRESSURE AND ARTERIAL STIFFNESS: IS BLOOD PRESSURE THE MAIN DETERMINANT OF WITHIN-SUBJECT VARIATION IN PULSE WAVE VELOCITY? Artery Research |
| title | P21 REDUCTION OF CARDIAC PRE-LOAD HAS ANTITHETICAL EFFECTS ON BLOOD PRESSURE AND ARTERIAL STIFFNESS: IS BLOOD PRESSURE THE MAIN DETERMINANT OF WITHIN-SUBJECT VARIATION IN PULSE WAVE VELOCITY? |
| title_full | P21 REDUCTION OF CARDIAC PRE-LOAD HAS ANTITHETICAL EFFECTS ON BLOOD PRESSURE AND ARTERIAL STIFFNESS: IS BLOOD PRESSURE THE MAIN DETERMINANT OF WITHIN-SUBJECT VARIATION IN PULSE WAVE VELOCITY? |
| title_fullStr | P21 REDUCTION OF CARDIAC PRE-LOAD HAS ANTITHETICAL EFFECTS ON BLOOD PRESSURE AND ARTERIAL STIFFNESS: IS BLOOD PRESSURE THE MAIN DETERMINANT OF WITHIN-SUBJECT VARIATION IN PULSE WAVE VELOCITY? |
| title_full_unstemmed | P21 REDUCTION OF CARDIAC PRE-LOAD HAS ANTITHETICAL EFFECTS ON BLOOD PRESSURE AND ARTERIAL STIFFNESS: IS BLOOD PRESSURE THE MAIN DETERMINANT OF WITHIN-SUBJECT VARIATION IN PULSE WAVE VELOCITY? |
| title_short | P21 REDUCTION OF CARDIAC PRE-LOAD HAS ANTITHETICAL EFFECTS ON BLOOD PRESSURE AND ARTERIAL STIFFNESS: IS BLOOD PRESSURE THE MAIN DETERMINANT OF WITHIN-SUBJECT VARIATION IN PULSE WAVE VELOCITY? |
| title_sort | p21 reduction of cardiac pre load has antithetical effects on blood pressure and arterial stiffness is blood pressure the main determinant of within subject variation in pulse wave velocity |
| url | https://www.atlantis-press.com/article/125930332/view |
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