Impact of Cardiovascular Factors on Pulse Wave Velocity and Total Vascular Resistance in Different Age Group Patients with Cardiovascular Disorders

Author(s): Amit Ghosh*, Abhijith Dharmarajan, Prafulla K. Swain, Debasish Das, Poonam Verma, Prabhas R. Tripathy.

Journal Name: Current Aging Science

Volume 11 , Issue 4 , 2018

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Graphical Abstract:


Background: Pulse Wave Velocity (PWV) is the propagation speed of the wave-induced along the aorta and arterial tree, each time the heart beats. PWV increases with increased arterial stiffness, thus establishing it as a reliable prognostic marker for cardiovascular morbidity and mortality. On the other hand, Total Vascular Resistance (TVR) is the overall resistance offered by systemic circulation and pulmonary circulation. This resistance needs to be overcome in order to create the flow of blood through the circulatory system. The goal of this study was to investigate the influence of different cardiovascular factors on arterial stiffness and vascular resistance in CVD patient from eastern India population.

Methods: Total of 782 patients with Cardiovascular Disease (CVD) like hypertension, Ischemic heart disease, Congestive cardiac failure and peripheral arterial disease were included to evaluate the cardiovascular hemodynamic and non-hemodynamic parameter by oscillometric method and investigated those factors on PWV and TVR in subjects of both sexes aged between 15 to 87 years.

Results: The old age (> 55 years) was found to have greatest impact on PWV as compared with younger age group. Systolic Blood Pressure (SBP), Heart Rate (HR), augmentation pressure and Body Surface Area (BSA) had a positive association with the PWV. Augmentation Index and Body Mass Index (BMI) had a negative impact on the PWV.

Conclusion: Despite the limitations, like unequal number of male and female participants, wide variation of the age of the subjects and analyzing association of many factors at a time, our large and community-based study show individual blood pressure and pulse pressure depending on complex interaction between large arteries and arterioles. This study sheds light on the relationship between proximal and distal part (PWV and TVR) of the arterial tree as well as their association with different hemodynamic and non-hemodynamic parameters.

Keywords: Cardiovascular factors, hypertension, pulse wave velocity, total vascular resistance, BSA, BMI.

Nag T, Ghosh A. Prevalence of cardiovascular disease risk factors in a rural community in West Bengal, India. Int J Med Public Health 2015; 5: 259-64.
Gérard M. Role of arterial wall properties in the pathogenesis of systolic hypertension. Am J Hypertens 2005; 18(S1): 19S-22S.
David NK. Blood flow in arteries. Annu Rev Fluid Mech 1997; 29: 399-434.
Lim HS, Lip GY. Arterial stiffness: Beyond pulse wave velocity and its measurement. J Hum Hypertens 2008; 22(10): 656-8.
Bogren HG, Mohiaddin RH, Klipstein RK, et al. The function of the aorta in ischemic heart disease: A magnetic resonance and angiographic study of aortic compliance and blood flow patterns. Am Heart J 1989; 118: 234-47.
Ohtsuka S, Kakihana M, Watanabe H, et al. Chronically decreased aortic distensibility causes deterioration of coronary perfusion during increased left ventricular contraction. J Am Coll Cardiol 1994; 24: 1406-14.
Hallock P, Benson IC. Studies on the elastic properties of human isolated aorta. J Clin Invest 1937; 16: 595-602.
Steppan J, Barodka V, Berkowitz DE, et al. Vascular stiffness and increased pulse pressure in the aging cardiovascular system. Cardiol Res Pract 2011; 263585: 8.
Yamashina A, Tomiyama H, Arai T, et al. Brachial-ankle pulse wave velocity as a marker of atherosclerotic vascular damage and cardiovascular risk. Hypertens Res 2003; 26(8): 615-22.
Kim YK. Impact of the metabolic syndrome and its components on pulse wave velocity. Korean J Intern Med 2006; 21(2): 109-15.
Avolio A. Arterial Stiffness Pulse (Basel) 2013; 1(1): 14-28.
Hamilton PK, Lockhart CJ, Quinn CE, et al. Arterial stiffness: Clinical relevance, measurement and treatment. Clin Sci (Lond) 2007; 113(4): 157-70.
Martinez-Lemus LA. The dynamic structure of arterioles. Basic Clin Pharmacol Toxicol 2012; 110(1): 5-11.
Laurent S, Briet M, Boutouyrie P. Large and small artery cross-talk and recent morbidity-mortality trials in hypertension. Hypertension 2009; 54(2): 388-92.
Puglisi V, Bramanti A, Lanza G, et al. Impaired cerebral haemodynamics in vascular depression: insights from transcranial doppler ultrasonography. Front Psychiatry 2018; 9: 316.
Lantelme P, Mestre P, Lievre M, et al. Heart rate an important confounder of pulse wave velocity assessment. Hypertension 2002; 39: 1083-7.
Zambanini A, Cunningham SL, Parker KH, et al. Wave-energy patterns in carotid, brachial, and radial arteries: A noninvasive approach using wave-intensity analysis. Am J Physiol Heart Circ Physiol 2005; 289: H270-6.
Kim EJ, Park CG, Park JS, et al. Relationship between blood pressure parameters and pulse wave velocity in normotensive and hypertensive subjects: Invasive stud. J Hum Hypertens 2007; 21: 141-8.
Hsu PH, Mathewson FAL, Rabkin SW. Blood pressure and body mass index patterns-A longitudinal study. J Chronic Dis 1977; 30(2): 93-113.
Yasmin, Brown MJ. Similarities and differences between augmentation index and pulse wave velocity in the assessment of arterial stiffness. QJM 1999; 92: 595-600.
Wilkinson IB, MacCallum H, Flint L, et al. The influence of heart rate on augmentation index and central arterial pressure in humans. J Physiol 2000; 525: 263-70.
Nordstrand N, Gjevestad E, Dinh KN, et al. The relationship between various measures of obesity and arterial stiffness in morbidly obese patients. BMC Cardiovasc Disord 2011; 11: 7.
Huisman HW, Schutte R, Venter HL, et al. Low BMI is inversely associated with arterial stiffness in Africans. Br J Nutr 2015; 113: 1621-7.
Laishram D, Glad MMI. Effect of body mass change on arterial wall elasticity in young adults. Int J Biol Med Res 2011; 2(4): 843-5.
Durmus I, Kazaz Z, Altun G, et al. Augmentation index and aortic pulse wave velocity in patients with abdominal aortic aneurysms. Int J Clin Exp Med 2014; 7(2): 421-5.
Pauca AL, O’Rourke MF, Kon ND. Prospective evaluation of a method for estimating ascending aortic pressure from the radial artery pressure waveform. Hypertension 2001; 38(4): 932-7.
Laurent S, Cockcroft J, Van Bortel L, et al. European network for non-invasive investigation of large arteries. expert consensus document on arterial stiffness: Methodological issues and clinical applications. Eur Heart J 2006; 27(21): 2588-605.
Burton Physiology and Biophysics of the Circulation Chicago: Year Book Medical Publishers 1972; Page 91.
Nelson MR, Stepanek J, Cevette M, et al. Noninvasive measurement of central vascular pressures with arterial tonometry: Clinical revival of the pulse pressure waveform? Mayo Clin Proc 2010; 85(5): 460-72.
Man in’t Veld AJ, van den Meiracker A, Schalekamp MA. The effect of beta blockers on total peripheral resistance. J Cardiovasc Pharmacol 1986; 8(4): S49-60.
Lund-Johansen P. Hemodynamic response: Decrease in cardiac output vs reduction in vascular resistance. Hypertension 1983; 5: 5.
Nelson MR, Stepanek J, Cevette M, et al. Noninvasive measurement of central vascular pressures with arterial tonometry: Clinical revival of the pulse pressure waveform? Mayo Clin Proc 2010; 85(5): 460-72.

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Article Details

Year: 2018
Page: [261 - 268]
Pages: 8
DOI: 10.2174/1874609812666190226151500

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