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Contribution of abnormal arterial function to cardiac syndrome X: a study of pressure waveform analysis and exercise haemodynamics

Journal of Human Hypertension volume 22, pages 217–219 (2008)Cite this article

Increased central systolic loading may contribute to ischaemic symptoms in cardiac syndrome X (CSX). Resting and exercise-induced central pressure waveforms were recorded in 20 CSX patients and 20 controls. Patients with CSX had significantly higher wave reflection and reduced pulse pressure amplification, which may help to explain symptoms in CSX.

The cardiac syndrome X (CSX) condition seriously impairs quality of life and is costly to the health-care system.1 Although the aetiology is probably multifactorial, there is evidence to implicate coronary microvascular dysfunction (leading to myocardial underperfusion) as playing a major role.2 However, studies have shown impaired brachial artery vasodilation3, 4 and microcirculatory derangement at multiple vascular beds in CSX patients,5 implying that arterial irregularities may be a systemic phenomenon. This may adversely affect cardiac function through increased arterial wave reflections.

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References

  1. Kaski JC . Pathophysiology and management of patients with chest pain and normal coronary arteriograms (cardiac syndrome X). Circulation 2004; 109: 568–572.

    Article  Google Scholar 

  2. Lanza GA . Cardiac syndrome X: a critical overview and future perspectives. Heart 2006; doi:10.1136/hrt.2005.067330.

  3. Bellamy MF, Goodfellow J, Tweddel AC, Dunstan FDJ, Lewis MJ, Henderson AH . Syndrome X and endothelial dysfunction. Cardiovasc Res 1998; 40: 410–417.

    Article  CAS  Google Scholar 

  4. Masci PG, Laclaustra M, Lara JG, Kaski JC . Brachial artery flow-mediated dilation and myocardial perfusion in patients with cardiac syndrome X. Am J Cardiol 2005; 95: 1478–1480.

    Article  Google Scholar 

  5. Pasqui AL, Puccetti L, Di Renzo M, Bruni F, Camarri A, Palazzuoli A et al. Structural and functional abnormality of systemic microvessels in cardiac syndrome X. Nutr Metab Cardiovasc Dis 2005; 15: 56–64.

    Article  CAS  Google Scholar 

  6. O'Rourke MF, Pauca AL . Augmentation of the aortic and central arterial pressure waveform. Blood Press Monit 2004; 9: 179–185.

    Article  Google Scholar 

  7. Sharman JE, Lim R, Marwick TH . Cardiac syndrome X: relevance of arterial pressure waveform analysis to patients with chest pain and normal coronary arteries. J Hum Hypertens 2006; 20: 473–474.

    Article  CAS  Google Scholar 

  8. Sharman JE, Lim R, Qasem AM, Coombes JS, Burgess MI, Franco J et al. Validation of a generalized transfer function to noninvasively derive central blood pressure during exercise. Hypertension 2006; 47: 1203–1208.

    Article  CAS  Google Scholar 

  9. O'Rourke MF, Pauca A, Jiang XJ . Pulse wave analysis. Br J Clin Pharmacol 2001; 51: 507–522.

    Article  CAS  Google Scholar 

  10. Lanza GA, Fox K, Crea F . Heart rate: a risk factor for cardiac diseases and outcomes? Pathophysiology of cardiac diseases and the potential role of heart rate slowing. Adv Cardiol 2006; 43: 1–16.

    PubMed  Google Scholar 

  11. Wilkinson IB, MacCallum H, Flint L, Cockcroft JR, Newby DE, Webb DJ . The influence of heart rate on augmentation index and central arterial pressure in humans. J Physiol 2000; 525: 263–270.

    Article  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Medicine, Princess Alexandra Hospital, University of Queensland, Brisbane, Queensland, Australia

    J E Sharman, J L Hare & T H Marwick

  2. School of Human Movement Studies, University of Queensland, Brisbane, Queensland, Australia

    J E Sharman & D J Holland

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  1. J E Sharman
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  2. D J Holland
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  3. J L Hare
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  4. T H Marwick
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Correspondence to J E Sharman.

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Sharman, J., Holland, D., Hare, J. et al. Contribution of abnormal arterial function to cardiac syndrome X: a study of pressure waveform analysis and exercise haemodynamics. J Hum Hypertens 22, 217–219 (2008). https://doi.org/10.1038/sj.jhh.1002294

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