title: Central pulse pressure is a determinant of heart and brain remodeling in the elderly: a quantitative MRI and PET pilot study.
abstract: OBJECTIVE
  The sustained elevation of blood pressure (BP) and especially of central pulse pressure (cPP) leads to heart and brain damage. This pilot study was aimed to precise the relationships between peripheral and central BP levels, and the remodeling of heart and brain as objectively quantified by cardiac MRI and brain F-fluorodeoxyglucose (FDG)-PET imaging in the elderly.
  
  
  METHODS
  Twenty-eight apparently healthy elderly individuals (66-85 years old, 14 women) were prospectively recruited and allocated into two half groups, one with and one without hypertension, and all were referred for the quantitative determinations of peripheral and central BP using applanation tonometry, indexed left ventricular mass (per m of body surface area) using cardiac MRI, and brain metabolism with a voxel-based analysis of FDG-PET images adjusted for age and sex.
  
  
  RESULTS
  Indexed left ventricular mass, reflecting cardiac remodeling, was correlated with the overall pressure variables involving both peripheral and central levels of systolic and pulse pressure (all P ≤ 0.001). By contrast, brain metabolism was significantly correlated with only cPP (P < 0.02). A cPP of at least 50  mmHg was associated with both a lower metabolism in frontal areas (P = 0.005) and a higher indexed left ventricular mass (P = 0.03).
  
  
  CONCLUSIONS
  This pilot study suggests that, when quantified by MRI and PET imaging, left ventricular mass and brain metabolism of elderly individuals are related to the cPP and to the 50  mmHg threshold, corresponding to what has previously been documented for the risk of cardiovascular event.
authors.affiliation: aDepartment of Nuclear Medicine, Nancyclotep Imaging Platform, CHU-Nancy bINSERM U947 cLorraine University, Nancy dDepartment of Nuclear Medicine, AP-HM, Hospital 'La Timone' eCNRS UMR7289, Institut de Neurosciences de la Timone, INT, Marseilles fINSERM, U1116, Nancy gINSERM, Centre d'Investigation Clinique CIC-IT 1433 hDepartment of Radiology, CHU-Nancy iINSERM, Centre d'Investigation Clinique CIC-P 9501 jDepartment of Geriatric Medicine, CHU-Nancy, Nancy, France.
authors.forename: Antoine
authors.initials: A
authors.lastname: Verger
authors.forename: Axel
authors.initials: A
authors.lastname: van der Gucht
authors.forename: Eric
authors.initials: E
authors.lastname: Guedj
authors.forename: Pierre-Yves
authors.initials: PY
authors.lastname: Marie
authors.forename: Gabriela
authors.initials: G
authors.lastname: Hossu
authors.forename: Damien
authors.initials: D
authors.lastname: Mandry
authors.forename: Olivier
authors.initials: O
authors.lastname: Morel
authors.forename: Mathieu
authors.initials: M
authors.lastname: Perrin
authors.forename: Renaud
authors.initials: R
authors.lastname: Fay
authors.forename: Athanase
authors.initials: A
authors.lastname: Benetos
authors.forename: Laure
authors.initials: L
authors.lastname: Joly
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure; D001795:Blood Pressure Determination; D001921:Brain / Q000378:metabolism / Q000473:pathology*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000503:physiopathology; D008279:Magnetic Resonance Imaging; D008297:Male; D009206:Myocardium / Q000378:metabolism / Q000473:pathology*; D010865:Pilot Projects; D011674:Pulse