Acute increases in heart rate via right atrial pacing significantly reduced augmentation index (r = -0.70, P < .001) without altering aortic pulse wave velocity.
Does acute heart rate change via right atrial pacing affect arterial stiffness and central versus peripheral pulse pressure in healthy subjects?
Acute increases in heart rate alter central pressure augmentation and pulse pressure amplification without affecting true aortic stiffness, demonstrating that peripheral pulse pressure is an unreliable surrogate for central hemodynamics during heart rate changes.
Effect estimate: r = -0.70
p-value: p=< .001
BACKGROUND: Pulse pressure and aortic pulse wave velocity, measures of arterial stiffness, are both important determinants of cardiovascular risk. However, assessment of peripheral pulse pressure does not always provide a reliable measure of changes in central pulse pressure or arterial stiffness. The aim of the present study was to assess the effect of acute changes in heart rate on arterial stiffness and on peripheral and central pulse pressure in healthy subjects. METHODS: Twenty subjects (age range, 20 to 72 years) were studied at cardiac catheterization. Pulse wave analysis was used to determine central pressure, augmentation index (AIx), a measure of systemic arterial stiffness, and aortic pulse wave velocity (PWV) during right atrial pacing (80 to 120 beats/min). RESULTS: Pulse pressure amplification increased during pacing due to a reduction in central pressure augmentation. AIx was significantly and inversely related to heart rate (r = -0.70, P < .001) due to an alteration in the relative timing of the reflected pressure wave, rather than a reduction in arterial stiffness, as PWV did not change. CONCLUSIONS: These data suggest that peripheral pulse pressure does not provide an accurate assessment of changes in central hemodynamics in relation to changes in heart rate, and that aortic stiffness is not affected by acute changes in heart rate.
Wilkinson et al. (2002) studied Healthy (n=20). Right atrial pacing was evaluated on Central pressure, augmentation index (AIx), and aortic pulse wave velocity (PWV) (r = -0.70, p=< .001). Acute increases in heart rate via right atrial pacing significantly reduced augmentation index (r = -0.70, P < .001) without altering aortic pulse wave velocity.