Artery Research

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.2017.10.020How 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 (SV3 + RaVL, 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 (SV3) and R wave in limb aVL lead (ReVL), 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.2017.10.020How to use a DOI?
Open Access
This is an open access article distributed under the CC BY-NC license.

Cite this article

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  -