Carotid Reservoir Pressure Decrease After Prolonged Head Down Tilt Bed Rest in Young Healthy Subjects Is Associated With Reduction in Left Ventricular Ejection Time and Diastolic Length

Frontiers in Physiology

Kim H. Parker¹  Paolo Salvi²  Michaela Kozakova³  Lorenzo Losso⁴  Massimo Pagani⁵  Alun D. Hughes⁶  Carlo Palombo⁷  Carmela Morizzo⁷ 

[1] Department of Bioengineering, Imperial College London, London, United Kingdom;Department of Cardiology, Istituto Auxologico Italiano, IRCCS, Milan, Italy;Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy;Department of Medical Toxicology Unit and Poison Control Centre, Careggi University Hospital, Florence, Italy;Department of Medicine, University of Milan, Milan, Italy;Department of Population Science and Experimental Medicine, University College of London, London, United Kingdom;Department of Surgical, Medical, Molecular Pathology and Critical Area Medicine, University of Pisa, Pisa, Italy;

关键词: head-down tilt bed rest;    arterial pressure waveform;    reservoir pressure;    excess pressure;    forward pressure wave;    backward pressure wave;   

DOI  :  10.3389/fphys.2022.866045

来源: DOAJ

【 摘 要 】

BackgroundThe arterial pressure waveform reflects the interaction between the heart and the arterial system and carries potentially relevant information about circulatory status. According to the commonly accepted ‘wave transmission model’, the net BP waveform results from the super-position of discrete forward and backward pressure waves, with the forward wave in systole determined mainly by the left ventricular (LV) ejection function and the backward by the wave reflection from the periphery, the timing and amplitude of which depend on arterial stiffness, the wave propagation speed and the extent of downstream admittance mismatching. However, this approach obscures the ‘Windkessel function’ of the elastic arteries. Recently, a ‘reservoir-excess pressure’ model has been proposed, which interprets the arterial BP waveform as a composite of a volume-related ‘reservoir’ pressure and a wave-related ‘excess’ pressure.MethodsIn this study we applied the reservoir-excess pressure approach to the analysis of carotid arterial pressure waveforms (applanation tonometry) in 10 young healthy volunteers before and after a 5-week head down tilt bed rest which induced a significant reduction in stroke volume (SV), end-diastolic LV volume and LV longitudinal function without significant changes in central blood pressure, cardiac output, total peripheral resistance and aortic stiffness. Forward and backward pressure components were also determined by wave separation analysis.ResultsCompared to the baseline state, bed rest induced a significant reduction in LV ejection time (LVET), diastolic time (DT), backward pressure amplitude (bP) and pressure reservoir integral (INTPR). INTPR correlated directly with LVET, DT, time to the peak of backward wave (bT) and stroke volume, while excess pressure integral (INTXSP) correlated directly with central pressure. Furthermore, Δ.INTPR correlated directly with Δ.LVET, and Δ.DT, and in multivariate analysis INTPR was independently related to LVET and DT and INTXSP to central systolic BP.ConclusionThis is an hypothesis generating paper which adds support to the idea that the reservoir-wave hypothesis applied to non-invasively obtained carotid pressure waveforms is of potential clinical usefulness.

【 授权许可】

Unknown