Cardiology Medical News about central pulse pressure, arterial stiffness, wave reflection, augmentation pressure, aortic diameter

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Increased wave reflection rather than central arterial stiffness is the main determinant of raised pulse pressure in women and relates to mismatch in arterial dimensions: A twin study
JACC - Journal of the American College of Cardiology, 08/18/09

Cecelja M et al. – Results suggest that, in women, augmentation pressure ({Delta}Paug) is highly heritable, is associated with the ratio of distal to proximal arterial diameters, and, independent of pulse wave velocity (PWV), is a major determinant of central pulse pressure (cPP).

Methods

Study of the relative contributions of the first systolic shoulder (P1) and {Delta}Paug to cPP, their relation to central arterial stiffness (PWV) and arterial diameters, and their respective heritability estimates
Assesment of 496women from Twins UK adult twin registry: 112 monozygotic, 135 dizygotic pairs; age 21-81 yrs
SphygmoCor system from transformed radial waveforms to estimate cPP, P1, {Delta}Paug, and carotid-femoral PWV
Ultrasonography to measure aortic and femoral artery diameters
Structural equation modeling to estimate heritability

Results

P1 and {Delta}Paug: 22% and 76%, respectively, of variance in cPP
After adjustment for mean arterial pressure and heart rate, P1 strongly independently positively correlated with PWV
{Delta}Paug did not independently correlate with PWV but independently negatively correlated with ratio of diameter of femoral aorta vs abdominal aorta
Estimates of heritability (h2) of cPP, PWV, P1, and {Delta}Paug: 0.43, 0.34, 0.31, and 0.62, respectively, after adjustment for mean arterial pressure and heart rate

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