What is the clinical evidence from this study?

Study design: RCT. Population: Healthy volunteers (n=41). Intervention: Isoprenaline vs. Placebo (glucose 5%). Primary outcome: Changes in augmentation index (AI), pulse pressure (PP), and pulse wave velocity (PWV).

March 1, 2004

Validity of pulse pressure and augmentation index as surrogate measures of arterial stiffness during beta-adrenergic stimulation

Key Result

Beta-adrenergic stimulation with isoprenaline increased pulse pressure and decreased augmentation index without altering aortic pulse wave velocity, failing as surrogate measures of arterial stiffness.

Study Design

Type

RCT (n=41)

Blinding

Double-blind

Randomization

Cross-over

Structured PICO

Are pulse pressure and augmentation index valid surrogate measures of arterial stiffness compared with pulse wave velocity during beta-adrenergic stimulation with Isoprenaline in healthy volunteers?

Population

41 healthy volunteers

Intervention

Intravenous infusion of Isoprenaline 8 microg/kg per min (dissolved in glucose 5%)

Comparator

Intravenous infusion of placebo (glucose 5%) in equal volume

Outcome

Arterial stiffness measured by pulse wave velocity (PWV), aortic augmentation index (AI), and pulse pressure (PP)surrogate

Augmentation index and pulse pressure fail as valid surrogate measures of arterial stiffness during beta-adrenergic stimulation.

Abstract

OBJECTIVE: Increased arterial stiffness is a determinant of cardiovascular mortality. Pulse wave velocity (PWV) is a direct measure of arterial stiffness. Aortic augmentation index (AI) and pulse pressure (PP) are surrogate measures of arterial stiffness. Both PWV, AI and PP increase with cardiovascular risk factors. The aim of this study was to test the validity of AI and PP as surrogate measures of arterial stiffness compared with PWV, during beta-adrenergic stimulation with Isoprenaline (Iso). DESIGN AND METHODS: A total of 41 healthy volunteers entered a randomized, double-blind, placebo-controlled, cross-over study. In random order, subjects were given intravenous infusion in equal volume of Iso 8 microg/kg per min (dissolved in glucose 5%) and placebo (glucose 5%). A wash-out period of 25 min was observed between the infusions. Measurements included blood pressure (BP), heart rate (HR), PWV, and AI. PWV were determined using complior (Complior, Artech-Medical, Paris, France). AI and aortic PP were obtained from pulse wave analysis of radial applanation tonometry, using transfer function (SphygmoCor Windows software). RESULTS: Baseline AI increased (P < 0.05) with aging, a lower height and a larger diastolic BP (DBP). Iso increased (P < 0.0001) HR, brachial SBP, brachial and aortic PP as compared with placebo. In contrast, Iso decreased (P < 0.05) AI, brachial DBP, peripheral PWV, but not aortic PWV. Decrease of AI induced by Iso was not related to PWV. In stepwise multiple regression changes in HR, brachial SBP and DBP were independent determinants of AI response to Iso (r = 0.78, P < 0.0001). CONCLUSIONS: Our findings show that AI and PP fail as surrogate measures of arterial stiffness during beta-adrenergic stimulation.

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Cite This Study

Lemogoum et al. (Mon,) conducted a rct in Healthy volunteers (n=41). Isoprenaline vs. Placebo (glucose 5%) was evaluated on Changes in augmentation index (AI), pulse pressure (PP), and pulse wave velocity (PWV). Beta-adrenergic stimulation with isoprenaline increased pulse pressure and decreased augmentation index without altering aortic pulse wave velocity, failing as surrogate measures of arterial stiffness.

synapsesocial.com/papers/6a0db3ac6e03bc61cb09e234 https://doi.org/https://doi.org/10.1097/00004872-200403000-00013

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