Aortic stiffness and the balance between cardiac oxygen supply and demand: the Rotterdam Study.
OBJECTIVE
Aortic stiffness is an independent predictor of cardiovascular morbidity and mortality. We investigated whether aortic stiffness, estimated as aortic pulse wave velocity, is associated with decreased perfusion pressure estimated as the cardiac oxygen supply potential.


METHODS
Aortic stiffness and aortic pressure waves, reconstructed from finger blood pressure waves, were obtained in 2490 older adults within the framework of the Rotterdam Study, a large population-based study. Cardiac oxygen supply and demand were estimated using pulse wave analysis techniques, and related to aortic stiffness by linear regression analyses after adjustment for age, sex, mean arterial pressure and heart rate.


RESULTS
Cardiac oxygen demand, estimated as the Systolic Pressure Time Index and the Rate Pressure Product, increased with increasing aortic stiffness [0.27 mmHg s (95% confidence interval: 0.21; 0.34)] and [42.2 mmHg/min (95% confidence interval: 34.1; 50.3)], respectively. Cardiac oxygen supply potential estimated as the Diastolic Pressure Time Index decreased [-0.70 mmHg s (95% confidence interval: -0.86; -0.54)] with aortic stiffening. Accordingly, the supply/demand ratio Diastolic Pressure Time Index/Systolic Pressure Time Index -1.11 (95% confidence interval: -0.14; -0.009) decreased with increasing aortic stiffness.


CONCLUSIONS
Aortic stiffness is associated with estimates of increased cardiac oxygen demand and a decreased cardiac oxygen supply potential. These results may offer additional explanation for the relation between aortic stiffness and cardiovascular morbidity and mortality.
Guelen
Ilja
I
BMEYE, Academic Medical Center, Amsterdam, The Netherlands.
Mattace-Raso
Francesco Us
FU
van Popele
Nicole M
NM
Westerhof
Berend E
BE
Hofman
Albert
A
Witteman
Jacqueline Cm
JC
Bos
Willem Jan W
WJ
D000368:Aged; D001011:Aorta / Q000502:physiology*; D001794:Blood Pressure / Q000502:physiology; D015331:Cohort Studies; D004548:Elasticity; D005260:Female; D006321:Heart / Q000502:physiology*; D006801:Humans; D008297:Male; D010100:Oxygen / Q000502:physiology*; D011673:Pulsatile Flow / Q000502:physiology
D010100:Oxygen