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The importance of calibration method in determining the association between central blood pressure with left ventricular and left atrial strain

Citation

Ramkumar, S and Yang, H and Nolan, M and Negishi, T and Marwick, TH and Negishi, K, The importance of calibration method in determining the association between central blood pressure with left ventricular and left atrial strain, International Journal of Cardiovascular Imaging ISSN 1569-5794 (2021) [Refereed Article]

Copyright Statement

© The Author(s), under exclusive licence to Springer Nature B.V. 2021

DOI: doi:10.1007/s10554-021-02444-4

Abstract

Afterload is an important determinant of left ventricular (LV) and atrial (LA) function, including myocardial strain. Central blood 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 blood pressure (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 both standard and MAP based calibration methods in 546 participants (age 70.7±4.7 years, 45% male) with risk factors for heart failure. 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 higher than standard CSBP (128±15 mmHg) and brachial SBP (140±17 mmHg, p<0.001), whereas DBPs were similar (84±10, 83±10, and 82±10 mmHg). MAP-derived CSBP was not independently associated with LV strain (p>0.05), however was independently associated with LA reservoir strain (p<0.05). Brachial and central DBP were more strongly associated with LA reservoir/conduit and LV strain than brachial and central SBP. LA pump strain was not independently associated with any SBP or DBP parameter (p>0.05). MAP-derived CBP was more accurate in identifying patients with abnormal LA and LV strain than brachial SBP and standard CBP calibration. In conclusion, CBP calibrated using MAP and DBP may be more accurate in identifying patients with abnormal LA and LV function than standard brachial calibration methods.

Item Details

Item Type:Refereed Article
Keywords:blood pressure, cardiac, cardiovascular, strain, left atrium, atrial function, central blood pressure
Research Division:Biomedical and Clinical Sciences
Research Group:Cardiovascular medicine and haematology
Research Field:Cardiology (incl. cardiovascular diseases)
Objective Division:Health
Objective Group:Clinical health
Objective Field:Clinical health not elsewhere classified
UTAS Author:Yang, H (Ms Hilda Yang)
UTAS Author:Nolan, M (Mr Mark Nolan)
UTAS Author:Negishi, T (Dr Tomoko Negishi)
UTAS Author:Marwick, TH (Professor Tom Marwick)
UTAS Author:Negishi, K (Dr Kazuaki Negishi)
ID Code:147333
Year Published:2021
Deposited By:Menzies Institute for Medical Research
Deposited On:2021-10-26
Last Modified:2021-11-17
Downloads:0

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