心率对脉搏波速度的影响：一项计算机模拟评估。

The impact of heart rate on pulse wave velocity: an in-silico evaluation.

机构信息

Laboratory of Hemodynamics and Cardiovascular Technology, Institute of Bioengineering, Swiss Federal Institute of Technology, Lausanne, Switzerland.

Biomedical Engineering Unit, 'Hippokration' Hospital, 1st Department of Cardiology, Medical School, National and Kapodistrian University of Athens, Athens, Greece.

出版信息

J Hypertens. 2020 Dec;38(12):2451-2458. doi: 10.1097/HJH.0000000000002583.

DOI:10.1097/HJH.0000000000002583

PMID:32740405

Abstract

BACKGROUND

Clinical and experimental evidence regarding the influence of heart rate (HR) on arterial stiffness and its surrogate marker carotid-to-femoral pulse wave velocity (cf-PWV) is conflicting. We aimed to evaluate the effect of HR on cf-PWV measurement under controlled haemodynamic conditions and especially with respect to blood pressure (BP) that is a strong determinant of arterial stiffness.

METHOD

Fifty-nine simulated cases were created using a previously validated in-silico model. For each case, cf-PWV was measured at five HR values, 60, 70, 80, 90, 100 bpm. With increasing HR, we assessed cf-PWV under two scenarios: with BP free to vary in response to HR increase, and with aortic DBP (aoDBP) fixed to its baseline value at 60 bpm, by modifying total peripheral resistance accordingly. Further, we quantified the importance of arterial compliance (C) on cf-PWV changes caused by increasing HR.

RESULTS

When BP was left free to vary with HR, a significant HR-effect on cf-PWV (0.66 ± 0.24 m/s per 10 bpm, P < 0.001) was observed. This effect was reduced to 0.21 ± 0.14 m/s per 10 bpm (P = 0.048) when aoDBP was maintained fixed with increasing HR. The HR-effect on the BP-corrected cf-PWV was higher in the case of low C = 0.8 ± 0.3 ml/mmHg (0.26 ± 0.15 m/s per 10 bpm, P = 0.014) than the case of higher C = 1.7 ± 0.5 ml/mmHg (0.16 ± 0.07 m/s per 10 bpm, P = 0.045).

CONCLUSION

Our findings demonstrated that relatively small HR changes may only slightly affect the cf-PWV. Nevertheless, in cases wherein HR might vary at a greater extent, a more clinically significant impact on cf-PWV should be considered.

摘要

背景

关于心率（HR）对动脉僵硬及其替代标志物颈股脉搏波速度（cf-PWV）的影响的临床和实验证据相互矛盾。我们旨在评估在控制血流动力学条件下 HR 对 cf-PWV 测量的影响，特别是考虑到血压（BP）是动脉僵硬的一个强决定因素。

方法

使用以前验证过的计算机模型创建了 59 个模拟病例。对于每个病例，在五个 HR 值（60、70、80、90、100 bpm）下测量 cf-PWV。随着 HR 的增加，我们在两种情况下评估 cf-PWV：随着 HR 增加，BP 自由变化，以及通过相应地修改总外周阻力，将主动脉舒张压（aoDBP）固定在 60 bpm 的基线值。此外，我们量化了动脉顺应性（C）对因 HR 增加引起的 cf-PWV 变化的重要性。

结果

当 BP 随 HR 自由变化时，cf-PWV 与 HR 之间存在显著的 HR 效应（每 10 bpm 增加 0.66±0.24 m/s，P<0.001）。当随着 HR 增加 aoDBP 保持固定时，这种效应降低至 0.21±0.14 m/s 每 10 bpm（P=0.048）。当 C 较低（C=0.8±0.3 ml/mmHg）时，HR 对校正后的 cf-PWV 的影响高于 C 较高（C=1.7±0.5 ml/mmHg）时的影响（每 10 bpm 增加 0.26±0.15 m/s，P=0.014 比每 10 bpm 增加 0.16±0.07 m/s，P=0.045）。