1.6 PERIPHERAL AND CENTRAL AMBULATORY BLOOD PRESSURE IN RELATION TO ECG VOLTAGE

Wen-Yi Yang; Blerim Mujaj; Ljupcho Efremov; Zhen-Yu Zhang; Lutgarde Thijs; Fang-Fei Wei; Qi-Fang Huang; Aernout Luttun; Peter Verhamme; Tim Nawrot; Jose Boggia; Jan Staessen

doi:10.1016/j.artres.2017.10.020

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Volume 20, Issue C, December 2017, Pages 48 - 49

1.6 PERIPHERAL AND CENTRAL AMBULATORY BLOOD PRESSURE IN RELATION TO ECG VOLTAGE

Authors

Wen-Yi Yang¹, Blerim Mujaj¹, Ljupcho Efremov¹, Zhen-Yu Zhang¹, Lutgarde Thijs¹, Fang-Fei Wei¹, Qi-Fang Huang¹, Aernout Luttun², Peter Verhamme², Tim Nawrot³, Jose Boggia⁴, Jan Staessen¹

¹Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, Faculty of Medicine, University of Leuven, Leuven, Belgium

²Centre for Molecular and Vascular Biology, KU Leuven Department of Cardiovascular Sciences, Faculty of Medicine, University of Leuven, Leuven, Belgium

³Centre for Environmental Sciences, Hasselt University, Diepenbeek, Belgium

⁴Unidad de Hipertensión Arterial, Departamento de Fisiopatología, Centro de Nefrología, Hospital de Clínicas, Universidad de la República, Montevideo Uruguay, Uruguay

Available Online 6 December 2017.

DOI

10.1016/j.artres.2017.10.020 How to use a DOI?

Abstract

Background: The heart ejects in the central elastic arteries. No previous study addressed the question whether ECG voltages are more closely associated with central than with peripheral blood pressure (BP).

Methods: Using the oscillometric Mobil-O-Graph 24 h PWA monitor, we measured brachial, central BP and central hemodynamics over 24 hours in 177 men (mean age, 29.1 years), and linked to ECG voltages.

Results: From wakefulness to sleep, as documented by diaries, systolic/diastolic BP decreased by 11.7/13.1 mmHg peripherally and by 9.3/13.6 mmHg centrally, whereas pulse pressure (PP) increased by 4.3 mmHg. Over 24 hours and the awake and asleep periods, the peripheral-minus-central differences in systolic/diastolic BPs and pulse pressure averaged 11.8/–1.6, 12.7/–1.8 and 10.3/–1.2 mmHg and 13.4, 14.4 and 11.5 mmHg, respectively (P < 0.0001). Cornel voltage and index averaged 1.18 mV and 114.8 mV×ms. The Cornell voltages were 0.104/0.086 and 0.082/0.105 mV higher in relation to brachial 24-h and asleep systolic/diastolic BP (per 1-SD), respectively, and 0.088/0.90 mV and 0.087/0.107 mV higher in relation to central BP. The corresponding estimates for the Cornel indexes were 9.6/8.6 and 8.2/105 mV×ms peripherally and 8.6/8.9 and 8.8/10.7 mV×ms centrally. The regression slopes were similar for brachial and central BP (P≥0.054). Associations of the ECG measurements with awake BP, PP, the augmentation ratio and pressure amplification did not reach significance.

	Cornell voltage (S_V3 + R_aVL, mV)				Cornell index (Cornell voltage × QRS duration, mV·ms)

	Peripheral BP		Central BP		Peripheral BP		Central BP

	Estimate (95% CI)	P	Estimate (95% CI)	P	Estimate (95% CI)	P	Estimate (95% CI)	P
Systolic BP
24-h	0.104 (0.016 to 0.191)	0.021	0.088 (0.0003 to 0.177)	0.049	9.61 (0.65 to 18.57)	0.036	8.58 (−0.40 to 17.56)	0.061
Awake	0.086 (−0.001 to 0.175)	0.054	0.062 (−0.026 to 0.151)	0.17	7.69 (−1.30 to 16.69)	0.093	5.80 (−3.23 to 14.82)	0.21
Asleep	0.082 (−0.006 to 0.170)	0.068	0.087 (−0.001 to 0.175)	0.053	8.17 (−0.82 to 17.16)	0.075	8.76 (−0.217 to 17.74)	0.056
Diastolic BP
24-h	0.086 (−0.002 to 0.174)	0.056	0.090 (0.002 to 0.178)	0.045	8.57 (−0.41 to 17.55)	0.061	8.93 (−0.04 to 17.90)	0.051
Awake	0.056 (−0.032 to 0.145)	0.21	0.060 (−0.029 to 0.149)	0.18	5.62 (−3.42 to 14.65)	0.22	5.97 (−3.06 to 15.00)	0.19
Asleep BP	0.105 (0.017 to 0.192)	0.020	0.107 (0.019 to 0.194)	0.017	10.53 (1.60 to 19.47)	0.021	10.71 (1.78 to 19.64)	0.019
Pulse pressure
24-h	0.040 (−0.049 to 0.129)	0.38	0.016 (−0.073 to 0.105)	0.72	3.07 (−5.99 to 12.13)	0.50	1.31 (−7.76 to 10.38)	0.77
Awake	0.048 (−0.041 to 0.137)	0.29	0.012 (−0.077 to 0.101)	0.78	3.63 (−5.43 to 12.68)	0.43	0.68 (−8.40 to 9.74)	0.88
Asleep	0.001 (−0.091 to 0.088)	0.98	0.001 (−0.087 to 0.090)	0.98	−0.29 (−9.37 to 8.78)	0.95	0.21 (−8.86 to 9.28)	0.96

ECG refers to electrocardiography. BP stands for blood pressure. Cornell voltage is the voltage sum of S wave in precordial V3 lead (S_V3) and R wave in limb aVL lead (R_eVL), while Cornell index is the product of QRS duration multiplied by the Cornell voltage. The estimate (95% Confidence Interval, CI) of the association was unadjusted and expressed as 1-SD increase of BP. P value is for significance of the estimate. The association estimates of Cornell voltage (P ≥ 0.054) and index (P ≥ 0.079) with central BP were not significantly different from those estimates with peripheral measurements.

Table

Association of ECG Cornell voltage and indexes with peripheral and central BP.

Conclusions: The diurnal rhythm of peripheral and central BP run in parallel. Central BP does not improve the association of Cornell voltage or index with peripheral BP.

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Journal: Artery Research
Volume-Issue: 20 - C
Pages: 48 - 49
Publication Date: 2017/12/06
ISSN (Online): 1876-4401
ISSN (Print): 1872-9312
DOI: 10.1016/j.artres.2017.10.020 How to use a DOI?
Open Access: This is an open access article distributed under the CC BY-NC license.

Cite this article

ris enw bib

TY  - JOUR
AU  - Wen-Yi Yang
AU  - Blerim Mujaj
AU  - Ljupcho Efremov
AU  - Zhen-Yu Zhang
AU  - Lutgarde Thijs
AU  - Fang-Fei Wei
AU  - Qi-Fang Huang
AU  - Aernout Luttun
AU  - Peter Verhamme
AU  - Tim Nawrot
AU  - Jose Boggia
AU  - Jan Staessen
PY  - 2017
DA  - 2017/12/06
TI  - 1.6 PERIPHERAL AND CENTRAL AMBULATORY BLOOD PRESSURE IN RELATION TO ECG VOLTAGE
JO  - Artery Research
SP  - 48
EP  - 49
VL  - 20
IS  - C
SN  - 1876-4401
UR  - https://doi.org/10.1016/j.artres.2017.10.020
DO  - 10.1016/j.artres.2017.10.020
ID  - Yang2017
ER  -

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