title: Heart Rate Dependency of Large Artery Stiffness.
abstract: Carotid-femoral pulse wave velocity (cfPWV) quantifies large artery stiffness, it is used in hemodynamic research and is considered a useful cardiovascular clinical marker. cfPWV is blood pressure (BP) dependent. Intrinsic heart rate (HR) dependency of cfPWV is unknown because increasing HR is commonly accompanied by increasing BP. This study aims to quantify cfPWV dependency on acute, sympathovagal-independent changes in HR, independent of BP. Individuals (n=52, age 40-93 years, 11 female) with in situ cardiac pacemakers or cardioverter defibrillators were paced at 60, 70, 80, 90, and 100 bpm. BP and cfPWV were measured at each HR. Both cfPWV (mean [95% CI], 0.31 [0.26-0.37] m/s per 10 bpm; P<0.001) and central aortic diastolic pressure (3.78 [3.40-4.17] mm Hg/10 bpm; P<0.001) increased with HR. The HR effect on cfPWV was isolated by correcting the BP effects by 3 different methods: (1) statistically, by a linear mixed model; (2) mathematically, using an exponential relationship between BP and cross-sectional lumen area; and (3) using measured BP dependency of cfPWV derived from changes in BP induced by orthostatic changes (seated and supine) in a subset of subjects (n=17). The BP-independent effects of HR on cfPWV were quantified as 0.20 [0.11-0.28] m/s per 10 bpm (P<0.001, method 1), 0.16 [0.11-0.22] m/s per 10 bpm (P<0.001, method 2), and 0.16 [0.11-0.21] m/s per 10 bpm (P<0.001, method 3). With a mean HR dependency in the range of 0.16 to 0.20 m/s per 10 bpm, cfPWV may be considered to have minimal physiologically relevant changes for small changes in HR, but larger differences in HR must be considered as contributing to significant differences in cfPWV.
authors.affiliation: From the Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, NSW, Australia (I.T., B.S., H.K., E.B., A.P.A., M.B.); Department of Biomedical Engineering, CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, The Netherlands (B.S., K.D.R., T.D.); and Cardiac Health Institute (H.K.) and Macquarie Heart (E.B.), Macquarie University Hospital, Sydney, NSW, Australia.
authors.forename: Isabella
authors.initials: I
authors.lastname: Tan
authors.affiliation: From the Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, NSW, Australia (I.T., B.S., H.K., E.B., A.P.A., M.B.); Department of Biomedical Engineering, CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, The Netherlands (B.S., K.D.R., T.D.); and Cardiac Health Institute (H.K.) and Macquarie Heart (E.B.), Macquarie University Hospital, Sydney, NSW, Australia.
authors.forename: Bart
authors.initials: B
authors.lastname: Spronck
authors.affiliation: From the Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, NSW, Australia (I.T., B.S., H.K., E.B., A.P.A., M.B.); Department of Biomedical Engineering, CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, The Netherlands (B.S., K.D.R., T.D.); and Cardiac Health Institute (H.K.) and Macquarie Heart (E.B.), Macquarie University Hospital, Sydney, NSW, Australia.
authors.forename: Hosen
authors.initials: H
authors.lastname: Kiat
authors.affiliation: From the Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, NSW, Australia (I.T., B.S., H.K., E.B., A.P.A., M.B.); Department of Biomedical Engineering, CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, The Netherlands (B.S., K.D.R., T.D.); and Cardiac Health Institute (H.K.) and Macquarie Heart (E.B.), Macquarie University Hospital, Sydney, NSW, Australia.
authors.forename: Edward
authors.initials: E
authors.lastname: Barin
authors.affiliation: From the Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, NSW, Australia (I.T., B.S., H.K., E.B., A.P.A., M.B.); Department of Biomedical Engineering, CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, The Netherlands (B.S., K.D.R., T.D.); and Cardiac Health Institute (H.K.) and Macquarie Heart (E.B.), Macquarie University Hospital, Sydney, NSW, Australia.
authors.forename: Koen D
authors.initials: KD
authors.lastname: Reesink
authors.affiliation: From the Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, NSW, Australia (I.T., B.S., H.K., E.B., A.P.A., M.B.); Department of Biomedical Engineering, CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, The Netherlands (B.S., K.D.R., T.D.); and Cardiac Health Institute (H.K.) and Macquarie Heart (E.B.), Macquarie University Hospital, Sydney, NSW, Australia.
authors.forename: Tammo
authors.initials: T
authors.lastname: Delhaas
authors.affiliation: From the Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, NSW, Australia (I.T., B.S., H.K., E.B., A.P.A., M.B.); Department of Biomedical Engineering, CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, The Netherlands (B.S., K.D.R., T.D.); and Cardiac Health Institute (H.K.) and Macquarie Heart (E.B.), Macquarie University Hospital, Sydney, NSW, Australia. alberto.avolio@mq.edu.au.
authors.forename: Alberto P
authors.initials: AP
authors.lastname: Avolio
authors.affiliation: From the Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, NSW, Australia (I.T., B.S., H.K., E.B., A.P.A., M.B.); Department of Biomedical Engineering, CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, The Netherlands (B.S., K.D.R., T.D.); and Cardiac Health Institute (H.K.) and Macquarie Heart (E.B.), Macquarie University Hospital, Sydney, NSW, Australia.
authors.forename: Mark
authors.initials: M
authors.lastname: Butlin
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D062186:Arterial Pressure / Q000502:physiology*; D001794:Blood Pressure / Q000502:physiology*; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000628:therapy; D002339:Carotid Arteries / Q000502:physiology; D003430:Cross-Sectional Studies; D017147:Defibrillators, Implantable; D005260:Female; D005263:Femoral Artery / Q000502:physiology; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010138:Pacemaker, Artificial; D011379:Prognosis; D063177:Pulse Wave Analysis; D018570:Risk Assessment; D012737:Sex Factors; D059289:Vascular Stiffness / Q000502:physiology*
keywords: blood pressure; heart rate; pulse wave analysis; pulse wave velocity