静息心率对脉搏波速度测量的影响受血压影响，并取决于主动脉僵硬度水平：来自科林斯研究的见解。

The influence of resting heart rate on pulse wave velocity measurement is mediated by blood pressure and depends on aortic stiffness levels: insights from the Corinthia study.

机构信息

First Department of Cardiology, Hippokration Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece. First Department of Cardiology, Biomedical Engineering Unit, Hippokration Hospital, 114 Vas. Sophias ave., Athens 11527, Greece. Author to whom any correspondence should be addressed. Equally contributed authors.

出版信息

Physiol Meas. 2019 Jun 4;40(5):055005. doi: 10.1088/1361-6579/ab165f.

DOI:10.1088/1361-6579/ab165f

PMID:30952147

Abstract

OBJECTIVE

Increased resting heart rate as well as increased arterial stiffness are both independent predictors of cardiovascular events and mortality. Results of previous studies have failed to converge concerning the association between heart rate and arterial stiffness, regardless of other potential confounders, such as age, gender and particularly blood pressure (BP). We aimed to investigate: (a) the degree of association (if any) between resting heart rate and carotid-to-femoral pulse wave velocity (PWV), the gold standard index of arterial stiffness, (b) if the relationship between heart rate and PWV is mediated by BP levels and (c) whether their association is affected by the levels of aortic stiffening.

APPROACH

Demographic, hemodynamic, laboratory and clinical data of 1566 subjects from the cross-sectional observational 'Corinthia' study were analyzed using univariate and multivariate regression models. Mediation analysis was performed to test whether mean arterial pressure (MAP) is a significant mediator in the heart rate-PWV relationship. The total population was divided in two groups of low and high arterial stiffness according to the median PWV value (8.6 m s).

MAIN RESULTS

We found that (i) there is a significant association between heart rate and PWV, regardless of other confounding factors. An increase in heart rate by 20 b.p.m. can increase PWV by 0.5 m s. However, this association was significant only for subjects with increased aortic stiffness (PWV > 8.6 m s) and not for those with PWV ⩽ 8.6 m s. Further, (ii) heart rate-PWV association was partially mediated by MAP.

SIGNIFICANCE

Increased resting heart rate is related to increased aortic stiffness, only in subjects with stiffer aortas, regardless of BP and other risk factors and subjects' characteristics. The synergistic prognostic effect of increased arterial stiffness and elevated heart rate on target organ damage, cardiovascular events and mortality should be explored in future studies.

摘要

目的

静息心率升高和动脉僵硬度增加都是心血管事件和死亡的独立预测因素。尽管存在年龄、性别和血压（BP）等其他潜在混杂因素，但之前的研究结果未能就心率与动脉僵硬度之间的关联达成一致。我们旨在研究：（a）静息心率与颈动脉-股动脉脉搏波速度（PWV）之间（如果存在的话）关联程度，PWV 是动脉僵硬度的金标准指标；（b）心率与 PWV 之间的关系是否受 BP 水平的影响；（c）它们的关联是否受主动脉僵硬度的影响。

方法

使用单变量和多变量回归模型分析了来自横断面观察性“科林斯”研究的 1566 名受试者的人口统计学、血流动力学、实验室和临床数据。进行中介分析以测试平均动脉压（MAP）是否是心率-PWV 关系中的一个重要中介因素。根据中位数 PWV 值（8.6 m/s），将总人群分为低和高动脉僵硬度两组。

主要结果

我们发现：（i）无论其他混杂因素如何，心率与 PWV 之间存在显著关联。心率增加 20 次/分钟可使 PWV 增加 0.5 m/s。然而，这种关联仅在主动脉僵硬度增加（PWV>8.6 m/s）的受试者中显著，而在 PWV⩽8.6 m/s 的受试者中不显著。此外，（ii）心率-PWV 关联部分由 MAP 介导。