Age-Specific Acute Changes in Carotid-Femoral Pulse Wave Velocity With Head-up Tilt.

Autor:	Pucci G; Department of Medicine, University of Perugia, Unit of Internal Medicine, Terni University Hospital, Terni, Italy.; Department of Internal Medicine, Erasmus MC University Medical Center, Rotterdam, The Netherlands., Spronck B; Department of Biomedical Engineering, Yale University, New Haven, Connecticut, USA.; Department of Biomedical Engineering, CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, The Netherlands., Avolio AP; Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia., Tap L; Department of Internal Medicine, Erasmus MC University Medical Center, Rotterdam, The Netherlands., Vaudo G; Department of Medicine, University of Perugia, Unit of Internal Medicine, Terni University Hospital, Terni, Italy., Anastasio F; Unit of Cardiology, ASST-VAL Hospital of Sondrio, Sondrio, Italy., Van Den Meiracker A; Department of Internal Medicine, Erasmus MC University Medical Center, Rotterdam, The Netherlands., Mattace-Raso F; Department of Internal Medicine, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
Jazyk:	angličtina
Zdroj:	American journal of hypertension [Am J Hypertens] 2020 Dec 31; Vol. 33 (12), pp. 1112-1118.
DOI:	10.1093/ajh/hpaa101
Abstrakt:	Background: Aortic stiffness as measured by carotid-femoral pulse wave velocity (cfPWV) is known to depend on blood pressure (BP), and this dependency may change with age. Therefore, the hydrostatic BP gradient resulting from a change in body posture may elicit a cfPWV change that is age-dependent. We aimed to analyze the relationship between BP gradient-induced by head-up body tilting-and related changes in cfPWV in individuals of varying age. Methods: cfPWV and other hemodynamic parameters were measured in 30 healthy individuals at a head-up tilt of 0° (supine), 30°, and 60°. At each angle, the PWV gradient and resulting cfPWV were also estimated (predicted) by assuming a global nonlinear, exponential, pressure-diameter relationship characterized by a constant β0, and taking into account that (diastolic) foot-to-foot cfPWV acutely depends on diastolic BP. Results: cfPWV significantly increased upon body tilting (8.0 ± 2.0 m/s supine, 9.1 ± 2.6 m/s at 30°, 9.5 ± 3.2 m/s at 60°, P for trend <0.01); a positive trend was also observed for heart rate (HR; P < 0.01). When the observed, tilt-induced cfPWV change measured by applanation tonometry was compared with that predicted from the estimated BP hydrostatic gradient, the difference in observed-vs.-predicted PWV change increased nonlinearly as a function of age (R2 for quadratic trend = 0.38, P < 0.01, P vs. linear = 0.04). This result was unaffected by HR tilt-related variations (R2 for quadratic trend = 0.37, P < 0.01, P vs. linear = 0.04). Conclusions: Under a hydrostatic pressure gradient, the pulse wave traveling along the aorta undergoes an age-related, nonlinear PWV increase exceeding the increase predicted from BP dependency. (© The Author(s) 2020. Published by Oxford University Press on behalf of American Journal of Hypertension, Ltd.)
Databáze:	MEDLINE
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