title: Exaggerated differences in pulse wave velocity between left and right sides among patients with anxiety disorders and cardiovascular disease.
abstract: OBJECTIVE
  To compare the left-right differences in pulse wave velocity (PWV) measures in normal controls and patients with anxiety disorders and cardiac disease. Pulses from the right and left sides of normal subjects are highly correlated at each segmental level. However, some evidence suggests that the right hemisphere has a greater effect on parasympathetic activity, as there may be a right hemisphere disadvantage in patients with low cardiac vagal function. Decreased vagal function is associated with vascular dysfunction and hypertension.
  
  
  METHODS
  We compared normal controls (n = 22), patients with anxiety (n = 26), and patients with cardiovascular disease (n = 72) using the Vascular Profiler (VP-1000), which enables the measurement of ankle and brachial blood pressure (BP) in both arms (brachial), both legs (ankle) and carotid artery, and lead I electrocardiogram and phonocardiogram. Using these signals, PWV, and arterial stiffness index % were calculated for the comparison of these measures on the right and left sides of the body.
  
  
  RESULTS
  Patients with anxiety and cardiovascular disease had significantly higher left-right differences in heart-ankle pulse wave velocity, brachial-ankle pulse wave velocity, and arterial stiffness index percentage compared with that of normal controls. Our data also showed significant differences between left-right vascular indices in patients with anxiety and cardiovascular disease (p < .00001); there was no such significant difference in normal controls.
  
  
  CONCLUSIONS
  These results may implicate an exaggerated vagal withdrawal in the left extremities resulting in higher PWV in patients with anxiety and cardiovascular illness.
authors.affiliation: Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, Michigan, USA. Vikramyershr@yahoo.com
authors.forename: Vikram Kumar
authors.initials: VK
authors.lastname: Yeragani
authors.forename: Rahul
authors.initials: R
authors.lastname: Kumar
authors.forename: Karl Juergen
authors.initials: KJ
authors.lastname: Bar
authors.forename: Pratap
authors.initials: P
authors.lastname: Chokka
authors.forename: Manuel
authors.initials: M
authors.lastname: Tancer
mesh_terms: D000328:Adult; D000842:Ankle / Q000098:blood supply; D001008:Anxiety Disorders / Q000503:physiopathology*; D001794:Blood Pressure / Q000502:physiology*; D001916:Brachial Artery / Q000502:physiology; D002318:Cardiovascular Diseases / Q000503:physiopathology*; D016022:Case-Control Studies; D004548:Elasticity; D005260:Female; D007839:Functional Laterality; D006801:Humans; D008297:Male; D008875:Middle Aged; D014630:Vagus Nerve / Q000502:physiology