Heart rate dependency of pulse pressure amplification and arterial stiffness.
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.
Wilkinson
Ian B
IB
Clinical Pharmacology Unit, University of Edinburgh, Western General Hospital, United Kingdom. ibw20@cam.ac.uk
Mohammad
Nadia Haj
NH
Tyrrell
Sian
S
Hall
Ian R
IR
Webb
David J
DJ
Paul
Vince E
VE
Levy
Terry
T
Cockcroft
John R
JR
D000328:Adult; D000368:Aged; D001011:Aorta / Q000502:physiology*; D001794:Blood Pressure / Q000502:physiology*; D006328:Cardiac Catheterization; D003187:Compliance; D005260:Female; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010138:Pacemaker, Artificial; D011673:Pulsatile Flow / Q000502:physiology; D013617:Tachycardia, Supraventricular / Q000503:physiopathology