P7.09 PULSE WAVE ANALYSIS REVEALS THAT MYOCARDIAL ISCHAEMIA IS NOT LIKELY TO EXPLAIN THE ‘J-CURVE’ ASSOCIATION BETWEEN DIASTOLIC BLOOD PRESSURE AND MORTALITY

M.G. Schultz; W.P. Abhayaratna; J.E. Sharman

doi:10.1016/j.artres.2011.10.116

<Previous Article In Issue

Download article (PDF)

Next Article In Issue>

Volume 5, Issue 4, December 2011, Pages 181 - 181

P7.09 PULSE WAVE ANALYSIS REVEALS THAT MYOCARDIAL ISCHAEMIA IS NOT LIKELY TO EXPLAIN THE ‘J-CURVE’ ASSOCIATION BETWEEN DIASTOLIC BLOOD PRESSURE AND MORTALITY

Authors

M.G. Schultz¹, W.P. Abhayaratna², J.E. Sharman¹

¹Menzies Research Institute Tasmania, University of Tasmania., Hobart, Australia

²Australia National University, Canberra Hospital, Canberra, Australia

Available Online 29 November 2011.

DOI: 10.1016/j.artres.2011.10.116 How to use a DOI?
Open Access: This is an open access article distributed under the CC BY-NC license.

Background: There is a well-established ‘J-curve’ relationship between brachial DBP and mortality. A purported, although unconfirmed mechanism for the “J-curve” is reduced myocardial perfusion due to low DBP. However, we hypothesised this would be unlikely because DBP may be a poor marker of myocardial perfusion. This study aimed to determine the relationship between DBP and subendocardial perfusion in patients with and without coronary artery disease (CAD).

Methods: 134 patients with CAD (aged 76±7 years; 69% male) and 134 matched healthy controls (HC) (aged 77±2 years; 69% male) underwent measurement of brachial DBP and radial tonometry to derive subendocardial viability ratio (SEVR), a marker of subendocardial perfusion. These measures were additionally undertaken in 47 patients (aged 63±10 years) at baseline and during peak dobutamine stress echocardiography in presence or absence of myocardial ischaemia.

Results: There was no difference in DBP or SEVR between HC and CAD patients (P>0.05), nor was there a difference in SEVR across quartiles of DBP in CAD (P=0.07) or HC (P=0.14) patients. Associations between DBP and SEVR in HC (r=0.185, P=0.03) and CAD patients (r=0.204, P=0.02) were non significant after adjustment for age and height (p=0.07 and p=0.11, respectively). At peak dobutamine stress, SEVR was significantly reduced in patients with ischaemia versus those without inducible ischaemia (84±17 vs. 101±22 mmHg.s.min⁻¹, P=0.01). However, DBP was not significantly different (65±14 vs. 67±15 mmHg, P=0.32).

Conclusion: Brachial DBP is a poor marker of subendocardial perfusion, suggesting the ‘J-curve’ relationship between DBP and mortality is unlikely attributable to reduced myocardial perfusion.

<Previous Article In Issue

Download article (PDF)

Next Article In Issue>

Journal: Artery Research
Volume-Issue: 5 - 4
Pages: 181 - 181
Publication Date: 2011/11/29
ISSN (Online): 1876-4401
ISSN (Print): 1872-9312
DOI: 10.1016/j.artres.2011.10.116 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  - M.G. Schultz
AU  - W.P. Abhayaratna
AU  - J.E. Sharman
PY  - 2011
DA  - 2011/11/29
TI  - P7.09 PULSE WAVE ANALYSIS REVEALS THAT MYOCARDIAL ISCHAEMIA IS NOT LIKELY TO EXPLAIN THE ‘J-CURVE’ ASSOCIATION BETWEEN DIASTOLIC BLOOD PRESSURE AND MORTALITY
JO  - Artery Research
SP  - 181
EP  - 181
VL  - 5
IS  - 4
SN  - 1876-4401
UR  - https://doi.org/10.1016/j.artres.2011.10.116
DO  - 10.1016/j.artres.2011.10.116
ID  - Schultz2011
ER  -

download .riscopy to clipboard