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The Effects of Hemodynamic Changes on Pulse Wave Velocity in Cardiothoracic Surgical Patients

View Article: PubMed Central - PubMed

ABSTRACT

The effect of blood pressure on pulse wave velocity (PWV) is well established. However, PWV variability with acute hemodynamic changes has not been examined in the clinical setting. The aim of the present study is to investigate the effect of hemodynamic changes on PWV in patients who undergo cardiothoracic surgery. Using data from 25 patients, we determined blood pressure (BP), heart rate (HR), and the left ventricular outflow tract (LVOT) velocity-time integral. By superimposing the radial arterial waveform on the continuous wave Doppler waveform of the LVOT, obtained by transesophageal echo, we were able to determine pulse transit time and to calculate PWV, stroke volume (SV), cardiac output (CO), and systemic vascular resistance (SVR). Increases in BP, HR, and SVR were associated with higher values for PWV. In contrast increases in SV were associated with decreases in PWV. Changes in CO were not significantly associated with PWV.

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The relationship between PWV and HR, SV, CO, and SVR. Each line indicates a simple linear regression line within subject. (a) The relationship between PWV and HR. (b) The relationship between PWV and SV. (c) The relationship between PWV and CO. (d) The relationship between PWV and SVR. The median (IQR) slope and the median (IQR) P value are presented in each graph. CO: cardiac output, HR: heart rate, IQR: interquartile range, PWV: pulse wave velocity, SV: stroke volume, and SVR: systemic vascular resistance.
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fig3: The relationship between PWV and HR, SV, CO, and SVR. Each line indicates a simple linear regression line within subject. (a) The relationship between PWV and HR. (b) The relationship between PWV and SV. (c) The relationship between PWV and CO. (d) The relationship between PWV and SVR. The median (IQR) slope and the median (IQR) P value are presented in each graph. CO: cardiac output, HR: heart rate, IQR: interquartile range, PWV: pulse wave velocity, SV: stroke volume, and SVR: systemic vascular resistance.

Mentions: The linear regression lines demonstrate a relationship between PWV and HR, PWV and SV, PWV and CO, and PWV and SVR within individual patients (Figure 3). Given that each patient had a different linear regression line with a different P value, the overall trend for all regression lines was estimated by a linear mixed model and presented in Table 2. The estimated slope showing a relationship between PWV and HR was 0.026 (P < 0.001), between PWV and SV was −0.007 (P < 0.01), between PWV and CO was 0.05 (P > 0.05), and between PWV and SVR was 0.001 (P < 0.001) (Table 2). Hence, the increase in PWV was significantly associated with an increase in both HR and SVR. The effect of SV was opposite to the one of HR and SVR. An increasing SV corresponded to decreased PWV. Changes in CO were not significantly associated with changes in PWV.


The Effects of Hemodynamic Changes on Pulse Wave Velocity in Cardiothoracic Surgical Patients
The relationship between PWV and HR, SV, CO, and SVR. Each line indicates a simple linear regression line within subject. (a) The relationship between PWV and HR. (b) The relationship between PWV and SV. (c) The relationship between PWV and CO. (d) The relationship between PWV and SVR. The median (IQR) slope and the median (IQR) P value are presented in each graph. CO: cardiac output, HR: heart rate, IQR: interquartile range, PWV: pulse wave velocity, SV: stroke volume, and SVR: systemic vascular resistance.
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Related In: Results  -  Collection

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Show All Figures
getmorefigures.php?uid=PMC5120184&req=5

fig3: The relationship between PWV and HR, SV, CO, and SVR. Each line indicates a simple linear regression line within subject. (a) The relationship between PWV and HR. (b) The relationship between PWV and SV. (c) The relationship between PWV and CO. (d) The relationship between PWV and SVR. The median (IQR) slope and the median (IQR) P value are presented in each graph. CO: cardiac output, HR: heart rate, IQR: interquartile range, PWV: pulse wave velocity, SV: stroke volume, and SVR: systemic vascular resistance.
Mentions: The linear regression lines demonstrate a relationship between PWV and HR, PWV and SV, PWV and CO, and PWV and SVR within individual patients (Figure 3). Given that each patient had a different linear regression line with a different P value, the overall trend for all regression lines was estimated by a linear mixed model and presented in Table 2. The estimated slope showing a relationship between PWV and HR was 0.026 (P < 0.001), between PWV and SV was −0.007 (P < 0.01), between PWV and CO was 0.05 (P > 0.05), and between PWV and SVR was 0.001 (P < 0.001) (Table 2). Hence, the increase in PWV was significantly associated with an increase in both HR and SVR. The effect of SV was opposite to the one of HR and SVR. An increasing SV corresponded to decreased PWV. Changes in CO were not significantly associated with changes in PWV.

View Article: PubMed Central - PubMed

ABSTRACT

The effect of blood pressure on pulse wave velocity (PWV) is well established. However, PWV variability with acute hemodynamic changes has not been examined in the clinical setting. The aim of the present study is to investigate the effect of hemodynamic changes on PWV in patients who undergo cardiothoracic surgery. Using data from 25 patients, we determined blood pressure (BP), heart rate (HR), and the left ventricular outflow tract (LVOT) velocity-time integral. By superimposing the radial arterial waveform on the continuous wave Doppler waveform of the LVOT, obtained by transesophageal echo, we were able to determine pulse transit time and to calculate PWV, stroke volume (SV), cardiac output (CO), and systemic vascular resistance (SVR). Increases in BP, HR, and SVR were associated with higher values for PWV. In contrast increases in SV were associated with decreases in PWV. Changes in CO were not significantly associated with PWV.

No MeSH data available.


Related in: MedlinePlus