Heart rate, arterial stiffness, and wave reflections in paced patients
Heart rate, arterial stiffness, and wave reflections in paced patients
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DOI：
10.1161/hy1001.096210
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发表时间：
2001-10-01
期刊：
影响因子：
8.3
通讯作者：
Bénétos, A
中科院分区：
文献类型：
--
作者：
Albaladejo, P;Copie, X;Bénétos, A
心率（HR）和脉压（PP）升高对心血管风险具有累积效应，但HR大于或等于100 bpm除外。HR的增加如何影响PP水平从未被研究过。在11例起搏器监测患者中，在3个不同的HR水平测量主动脉（脉搏波分析）和数字（光电容积描记装置）血压，同时测定颈动脉尺寸（回声跟踪技术）、波反射（脉搏波分析）和主动脉脉搏波速度。HR增加与以下情况相关：（1）手指收缩压、舒张压和平均血压显著升高;（2）手指和颈动脉PP显著降低，颈动脉PP的降低比手指PP更显著，导致PP显著放大;以及（3）减少反向压力波返回心脏所需的时间，而动脉硬度没有任何变化。HR增加显著增强PP放大，导致外周血压升高，而中心血压无可比变化。这些结果对于更好地理解心血管风险和白大衣高血压的机制具有重要意义。
Elevated heart rate (HR) and pulse pressure (PP) have a cumulative effect on cardiovascular risk, with the exception of HR greater than or equal to 100 bpm. How an increase in HR may influence the PP level has never been investigated. In 11 patients with pacemaker monitoring, aortic (pulse-wave analysis) and digital (photoplethysmographic device) blood pressure were measured at 3 different levels of HR, together with determinations of carotid dimensions (echo tracking technique), wave reflections (pulse-wave analysis), and aortic pulse-wave velocity. Increased HR is associated with the following: (1) a significant increase of digital systolic, diastolic, and mean blood pressure; (2) a significant reduction of digital and carotid PP, with a more pronounced reduction of the carotid than of the digital PP, resulting in a significant PP amplification; and (3) a reduction in the time required for the backward pressure wave to return toward the heart, without any change of arterial stiffness. Increased HR significantly enhances PP amplification, leading to an increase of peripheral blood pressure without comparable change in central blood pressure. These results are important to consider for a better understanding of cardiovascular risk and the mechanism of white-coat hypertension.