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Abstract

Afterload is an important determinant of left ventricular (LV) and atrial (LA) function, including myocardial strain. Centralblood pressure (CBP) is the major component of cardiac afterload and independently associated with cardiovascular risk.However, the optimal means of calibrating CBP is unclear—standard CBP assessment uses systolic (SBP) and diastolic bloodpressure (DBP) from brachial waveforms, but calibration with mean pressure (MAP) and DBP purports to be more accurate.Therefore, we sought to determine which CBP is best associated with LA and LV strain. CBP was measured using bothstandard and MAP based calibration methods in 546 participants (age 70.7±4.7 years, 45% male) with risk factors for heartfailure. Echocardiography was performed in all patients and strain analysis conducted to assess LA/LV function. The associations of CBP with LA and LV strain were assessed using linear regression. MAP-derived CSBP (150±20 mmHg) was higherthan standard CSBP (128±15 mmHg) and brachial SBP (140±17 mmHg, p0.05), however wasindependently associated with LA reservoir strain (p0.05). MAP-derived CBP was more accurate in identifying patients with abnormal LA andLV strain than brachial SBP and standard CBP calibration. In conclusion, CBP calibrated using MAP and DBP may be moreaccurate in identifying patients with abnormal LA and LV function than standard brachial calibration methods.

Item Type:	Article
Authors/Creators:	Ramkumar, S and Yang, H and Nolan, M and Negishi, T and Marwick, TH and Negishi, K
Keywords:	blood pressure, cardiac, cardiovascular, strain, left atrium, atrial function, central blood pressure
Journal or Publication Title:	International Journal of Cardiovascular Imaging
Publisher:	Springer Netherlands
ISSN:	1569-5794
DOI / ID Number:	10.1007/s10554-021-02444-4
Copyright Information:	© The Author(s), under exclusive licence to Springer Nature B.V. 2021
Related URLs:	UTAS Profile: Marwick, TH Google Scholar: Negishi, K UTAS Profile: Negishi, K
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