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Determinants of pressure wave reflection: characterization by the transit time-independent reflected wave amplitude

Journal of Human Hypertension volume 25, pages 665–671 (2011)Cite this article

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Abstract

The effects of pressure wave reflection have been incompletely described by the central augmentation index (cAI) and augmented pressure (Pa). We therefore investigated the determinants of amplitude of the reflected wave (Pb), which is independent of the reflected wave transit time (RWTT) and has been shown to predict cardiovascular mortality in the general population. A total of 180 (117 men, mean age 68 years old) patients were recruited. Carotid pressure waveforms derived by tonometry at baseline and 3 min after administration of sublingual nitroglycerin (NTG) were calibrated and then decomposed into the forward and backward waves to yield Pb. The ratio of pre-ejection period/ejection time (PEP/ET) was measured. By stepwise multivariate analysis, independent determinants of Pb included brachial mean blood pressure (β=0.56, P<0.001), heart rate (β=−0.29, P<0.001), age (β=0.20, P<0.001), PEP/ET (β=−0.16, P=0.004) and height (β=−0.13, P=0.018). RWTT, body mass index and sex were significant independent determinants of Pa and cAI but did not contribute to Pb. Change of Pb but not Pa or cAI significantly predicted the changes of carotid systolic (r=0.550, P<0.001) and pulse pressure (r=0.618, P<0.001) after NTG. In conclusion, determinants of Pb differ from those of cAI and Pa. Pb is independent of sex and RWTT.

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Acknowledgements

This work was supported by the intramural grants (V97C1-101, V98C1-028 and V99C1-091) from Taipei Veterans General Hospital, Taiwan, Republic of China.

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Authors and Affiliations

  1. Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan

    C-F Liao, S-H Sung & W-C Yu

  2. Department of Medical Research and Education, Taipei Veterans General Hospital, Taipei, Taiwan

    H-M Cheng & C-H Chen

  3. Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan

    C-H Chen

  4. Department of Social Medicine, National Yang-Ming University, Taipei, Taiwan

    C-H Chen

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  1. C-F Liao
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Correspondence to C-H Chen.

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Liao, CF., Cheng, HM., Sung, SH. et al. Determinants of pressure wave reflection: characterization by the transit time-independent reflected wave amplitude. J Hum Hypertens 25, 665–671 (2011). https://doi.org/10.1038/jhh.2010.106

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