Is 24 hour central aortic pressure superior to single measurement of central aortic pressure in well controlled hypertensive patients

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
N Georgieva ◽  
A Borizanova-Petkova ◽  
E Kinova ◽  
A Goudev

Abstract Background Non-invasive measurements of 24 h ambulatory central aortic systolic pressure (24hCASP) is now feasible method than single measurement of CASP. There is growing interest in CASP as cardiovascular risk marker beyond conventional brachial blood pressure (BP). Pulse wave velocity estimates arterial stiffness, whereas CASP is representative of the BP in major organs. Purpose To evaluate non- invasive parameters for arterial stiffness using oscillometric method and to compare 24hCASP with single measurement of CASP in well-controlled hypertensive patients to detect target organ damage (TOD). Methods A total 95 patients (57±14 years) with hypertension, were separated in two groups: 22 patients with normal EA/Ees ratio (Arterial elastance (EA) and ventricular elastance (Ees)) and 73 hypertensive patients with decrease EA/Ees ratio, marker for ventriculo-arterial coupling. EA and Ees were calculated as and – systolic pressure/stroke volume and end-systolic pressure/end-systolic volume. Parameters for arterial stiffness – 24hCASP, ambulatory central systolic pressure (CASP), 24-hour pulse wave velocity (PWV24h) and ambulatory PWV were measured non-invasively with oscillometric method by Mobil-O-graph PWA. Results Statistically significant differences in parameters of vascular stiffness were found in patients with normal ventriculo-arterial coupling in comparison with disturbed EA/Ees: 24hCASP (107.64±9.19 vs. 116.64±16.7 mm Hg, p=0.02), CAP (117.45±9.26 vs. 128.42±16.15 mm Hg, p<0.0001). There were no statistically significant differences in PWV and PWV24h. Multiple regression analysis demonstrated that CAP (B=−0.264 p=0.003; 95% CI: −0.003–0.014) is independent predictor of TOD in hypertensive patients, than 24 hour central aortic pressure. Conclusion There is no superiority of 24hCASP than single measurment of CASP. CASP could predict preclinical damage and cardiovascular outcome. Funding Acknowledgement Type of funding source: None

2008 ◽  
Vol 10 (4) ◽  
pp. 295-303 ◽  
Author(s):  
Wilmer W. Nichols ◽  
Scott J. Denardo ◽  
Ian B. Wilkinson ◽  
Carmel M. McEniery ◽  
John Cockcroft ◽  
...  

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
N Georgieva ◽  
A Borizanova - Petkova ◽  
E Kinova ◽  
A Goudev

Abstract BACKGROUND Vascular stiffness and left atrial volume index (LAVI) are predictors of cardiovascular complications in hypertensive patients. The correlation of left atrium (LA) with left ventricle (LV) – arterial functional changes has not been well established. PURPOSE To investigate the relationship between LA remodeling and ventriculoarterial function. METHODS We studied 70 consecutive middle-aged patients (54 ± 13 years), separated in two groups: 55 with mild to moderate hypertension and duration up to 5 years and 15 healthy controls. All parameters for arterial stiffness – 24-hour central systolic pressure (cSys24h), central pulse pressure (cPP24h), augmentation index 24h (Aix24h) and 24-hour pulse wave velocity (PWV24h) were measured non–invasively with oscillometric method by Mobil-O-graph PWA. All patients underwent standard two-dimentional echocardiography with Spackle tracking analysis for LA and LV global longitudinal strain (GLS). RESULTS Statistically significant differences in parameters of vascular stiffness were found in patients with hypertension in comparison with healthy controls: cSys24h (116.64 ± 10.52 vs. 108.4 ± 6.19 mm Hg, p < 0.001), cPP24h (47.64 ± 9.43 vs. 40.4 ± 4.98 mmHg, p < 0.001), PWV24h (8.59 ± 1.49 vs. 6.29 ± 0.91 m/s, p < 0.0001). Patients with hypertension have higher LV filling pressures: E/e ratio (9.62 ± 3.13 vs. 7.62 ± 1.58, p < 0.006), higher velocities of A–wave transmitral blood flow (85.15 ± 16.88 vs. 64.57 ± 13.76 cm/s, p < 0.0001), dilated LA (LAVI: 33.78 ± 10.68 vs. 24.96 ± 4.89 ml/m², p < 0.001) and reduced LA GLS (29.34 ± 3.45 vs. 41.33 ± 4.37%, p < 0.0001) in comparison to control group. There were no statistically significant differences in Aix24h and cardiac output between the two groups. There is moderate positive correlation between LAVI with cPP24h (r = 0.491, p < 0.0001) and cSys24h (r = 0.366, p < 0.004). We found moderate positive correlation between LAVI and LV mass index (r = 0.386, p < 0.002). PWV24h correlated moderately and positively with LAVI (r = 0.404, p< 0.0001), and negatively with LA GLS (r = -0.471, p < 0.0001). CONCLUSION: LA remodeling is determined by the high 24-hour values of non-invasively measured central systolic pressure and pulse wave velocity. The parameters of arterial stiffness - cSys24h, cPP24h correlate positively with LA. PWV24h correlates negatively with reservoir strain of the left atrium. Using the method in clinical practice can improve risk stratification and therapeutic management. Further investigations are needed for prognostic and therapeutic value of LA remodeling.


2020 ◽  
Author(s):  
Olga Ivanova ◽  
Elena Maychuk ◽  
Irina Voevodina ◽  
Artemij Orlov

Objective: to study the relationship of obesity with arterial stiffness and dynamics of central aortic pressure in women of different ages with preserved and lost reproductive function. Materials and methods: 161 women were examined, who were divided into 3 groups. Two groups with preserved reproductive function: group 1 consisted of 52 young women from 18 to 30 years old (23.85.3 years); group 2 - 54 women aged from 31 to menopause (415.9 years). Group 3 included 55 postmenopausal women (55.45.8 years). All women underwent a clinical examination with anthropometry; questioning; 24-hour monitoring of the dynamics of blood pressure with the determination of indicators of arterial stiffness and daily aortic central pressure; determination of the carotid-femoral pulse wave velocity (cfPWV); study of vascular stiffness by volume sphygmography. Results: women in groups 2 and 3 were comparable in terms of the prevalence of general obesity (GO). Abdominal obesity (AO) was detected in 19.2% of the 1st group; 51.9% of the 2nd and 76.4% of the 3rd group. In 1st group AO has the strongest relationship with aortic pulse wave velocity PWVao (R=0.41, p=0.002) and the corrected to HR75 augmentation index Aixao (R=0.38, p=0.005). In 2nd group AO correlates with cfPWV (R=0.4, p=0.003); GO with PWVao (R=0.38, p=0.005) and aortic cardio-ankle vascular index CAVIao (R=0.48, p=0.001). In the 2nd group AO and GO are also interconnected with central and peripheral pressure. In 3rd group AO correlates with PWVao (R=0.33, p=0.01), cfPWV (R=0.32, p=0.02); GO with the index of the double product IDP (R=0.36, p=0.01). Conclusion: it is necessary to conduct a comprehensive assessment of arterial stiffness and daily dynamics of central aortic pressure in women of all ages, suffering from obesity and, first of all, its abdominal type, in order to early diagnosis of subclinical changes in the vascular wall and central hemodynamic disturbances.


2017 ◽  
Vol 02 (01) ◽  
pp. 020-025
Author(s):  
K. Krishna ◽  
M. Kiran ◽  
Indrani Garre

AbstractBackground: Emerging evidence favours Central aortic pressure as a better correlate of cardiovascular events than peripheral BP recorded with sphygmomanometer. Noninvasive devices to calculate the derived central aortic pressures are available now. We want to see the difference of BP between derived central BP vs manual recorded BP and to see whether these BP values are consistent among different sexes and age groups.Materials and methods: In the present study 63 consecutive patients both male and female who attended the cardiology outpatient department were studied. In all these patients blood pressure was recorded both manually by sphygmomanometer and by Mobil-O-Graph® Pulse Wave Analyser (ARC Solver). The Mobil-O-Graph ® system works on the oscillometric recording of pulse waves at the brachial artery site. We recorded the BP in sitting posture. We compared the derived central, manual and device measured BP, cardiac output, and pulse wave velocity between both genders.Results: Among the study population (63 patients) 20 were females and 43 were males with mean age of 58.92±10.9 yrs. The mean systolic and diastolic manually recorded peripheral BP was 127.25 ± 19.89 and 79.25 ± 8.58 mm of Hg respectively, whereas the mean peripheral SBP and DBP recorded by the device was 129.40 ± 21.21 and 81.56 ± 12.83 mm of Hg respectively (comparable p=0.6, 0.2). The mean central aortic SBP & DBP recorded by the device was 117.37 ± 19.17 and 81.67 ± 13.04 mm of Hg with the mean pulse wave velocity of 8.392 ± 1.741 m/sec. There was a statistically significant difference in the central aortic SBP and manual SBP (p=0.005), whereas the difference in DBP was not statistically significant (p=0.2). There is no statistically significant difference in the central and peripheral SBP and DBP recorded by the device among males and females. The device derived parameters including cardiac output, pulse wave velocity also did not show significant difference in both sexes.Conclusion: Derived central aortic systolic pressure recorded by the device is lower than the manually recorded pressure whereas there was no difference in diastolic BP. There is no difference in these BP recordings between the genders.


2013 ◽  
Vol 10 (5) ◽  
pp. 59
Author(s):  
O. V. Kozhevnikova ◽  
L. S. Namazova-Baranova ◽  
O. S. Logachyova ◽  
T. V. Margieva ◽  
I. V. Shirokova ◽  
...  

2020 ◽  
Vol 23 (1) ◽  
pp. 7-11
Author(s):  
P. Nikolov

The PURPUSE of the present study is changes in function and structure of large arteries in individuals with High Normal Arterial Pressure (HNAP) to be established. MATERIAL and METHODS: Structural and functional changes in the large arteries were investigated in 80 individuals with HNAP and in 45 with optimal arterial pressure (OAP). In terms of arterial stiffness, pulse wave velocity (PWV), augmentation index (AI), central aortic pressure (CAP), pulse pressure (PP) were followed up in HNAP group. Intima media thickness (IMT), flow-induced vasodilatation (FMD), ankle-brachial index (ABI) were also studied. RESULTS: Significantly increased values of pulse wave velocity, augmentation index, central aortic pressure, pulse pressure are reported in the HNAP group. In terms of IMT and ABI, being in the reference interval, there is no significant difference between HNAP and OAP groups. The calculated cardiovascular risk (CVR) in both groups is low. CONCLUSION: Significantly higher values of pulse wave velocity, augmentation index, central aortic pressure and pulse pressure in the HNAP group are reported.


Hypertension ◽  
2002 ◽  
Vol 40 (6) ◽  
Author(s):  
Andrew Zambanini ◽  
Simon A. McG Thom ◽  
Alun D. Hughes ◽  
Kim H. Parker

PLoS ONE ◽  
2018 ◽  
Vol 13 (9) ◽  
pp. e0203305 ◽  
Author(s):  
Mark A. Supiano ◽  
Laura Lovato ◽  
Walter T. Ambrosius ◽  
Jeffrey Bates ◽  
Srinivasan Beddhu ◽  
...  

2021 ◽  
Vol 39 (Supplement 1) ◽  
pp. e114-e115
Author(s):  
João Marcos De M Zanatta ◽  
Fábio Dos S Ricardi ◽  
Tatiana De A Rubio ◽  
Elizabeth E S Cestário ◽  
Luciana N Cosenso-Martin ◽  
...  

Angiology ◽  
2008 ◽  
Vol 60 (1) ◽  
pp. 82-86 ◽  
Author(s):  
Oladipupo Olafiranye ◽  
Ghazanfar Qureshi ◽  
Louis Salciccioli ◽  
Kinda Vernon-Jones ◽  
Charles Philip ◽  
...  

Background increased arterial stiffness is a predictor of cardiovascular events. The stroke volume (SV) to pulse pressure (PP) ratio is an estimate of arterial capacitance. Pulse wave velocity (PWV) is a measure of arterial stiffness. This study evaluated the effect of left ventricular (LV) SV on the SV/PP–PWV relationship. Methods 97 patients had applanation tonometry and echocardiography to measure arterial capacitance (SV/PP), PWV, and central aortic pressure. Results 50 patients had normal SV and 47 had low SV. For all patients, PWV inversely correlated with SV/PP. PWV and SV/PP correlated more strongly in the normal SV group than in the low SV group. Aortic PP was significantly correlated with PWV in all patients, in the normal SV group, and in the low SV group. Conclusion effective arterial capacitance correlates with PWV. The presence of decreased SV weakens the relationship.


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