Joakim Olbers1, Adam Gille1, Petter Ljungman2, Mårten Rosenqvist2, Jan Östergren3, Nils Witt1. 1. a Unit of Cardiology, Department of Clinical Science and Education , Södersjukhuset, Karolinska Institutet , Stockholm , Sweden. 2. b Department of Clinical Sciences, Department of Cardiology , Karolinska Institutet, Danderyd University Hospital , Stockholm , Sweden. 3. c Departments of Medicine and Emergency Medicine , Karolinska University Hospital, Karolinska Institutet , Stockholm , Sweden.
Abstract
PURPOSE: Atrial fibrillation (AF) is associated with an increased risk for cardiovascular morbidity and mortality, not entirely explained by thromboembolism. The underlying mechanisms for this association are largely unknown. Similarly, high blood pressure (BP) increases the risk for cardiovascular events. Despite this the interplay between AF and BP is insufficiently studied. The purpose of this study was to examine and quantify the beat-to-beat blood pressure variability in patients with AF in comparison to a control group of patients with sinus rhythm. MATERIALS AND METHODS: We studied 33 patients - 21 in atrial fibrillation and 12 in sinus rhythm - undergoing routine coronary angiography. Invasive blood pressure was recorded at three locations: radial artery, brachial artery and ascending aorta. Blood pressure variability, defined as average beat-to-beat blood pressure difference, was calculated for systolic and diastolic blood pressure at each site. RESULTS: We observed a significant difference (p < .001) in systolic and diastolic blood pressure variability between the atrial fibrillation and sinus rhythm groups at all locations. Systolic blood pressure variability roughly doubled in the atrial fibrillation group compared to the sinus rhythm group (4.9 and 2.4 mmHg respectively). Diastolic beat-to-beat blood pressure variability was approximately 6 times as high in the atrial fibrillation group compared to the sinus rhythm group (7.5 and 1.2 mmHg respectively). No significant difference in blood pressure variability was seen between measurement locations. CONCLUSIONS: Beat-to-beat blood pressure variability in patients with atrial fibrillation was substantially higher than in patients with sinus rhythm. Hemodynamic effects of this beat-to-beat variation in blood pressure may negatively affect vascular structure and function, which may contribute to the increased cardiovascular morbidity and mortality seen in patients with atrial fibrillation.
PURPOSE:Atrial fibrillation (AF) is associated with an increased risk for cardiovascular morbidity and mortality, not entirely explained by thromboembolism. The underlying mechanisms for this association are largely unknown. Similarly, high blood pressure (BP) increases the risk for cardiovascular events. Despite this the interplay between AF and BP is insufficiently studied. The purpose of this study was to examine and quantify the beat-to-beat blood pressure variability in patients with AF in comparison to a control group of patients with sinus rhythm. MATERIALS AND METHODS: We studied 33 patients - 21 in atrial fibrillation and 12 in sinus rhythm - undergoing routine coronary angiography. Invasive blood pressure was recorded at three locations: radial artery, brachial artery and ascending aorta. Blood pressure variability, defined as average beat-to-beat blood pressure difference, was calculated for systolic and diastolic blood pressure at each site. RESULTS: We observed a significant difference (p < .001) in systolic and diastolic blood pressure variability between the atrial fibrillation and sinus rhythm groups at all locations. Systolic blood pressure variability roughly doubled in the atrial fibrillation group compared to the sinus rhythm group (4.9 and 2.4 mmHg respectively). Diastolic beat-to-beat blood pressure variability was approximately 6 times as high in the atrial fibrillation group compared to the sinus rhythm group (7.5 and 1.2 mmHg respectively). No significant difference in blood pressure variability was seen between measurement locations. CONCLUSIONS: Beat-to-beat blood pressure variability in patients with atrial fibrillation was substantially higher than in patients with sinus rhythm. Hemodynamic effects of this beat-to-beat variation in blood pressure may negatively affect vascular structure and function, which may contribute to the increased cardiovascular morbidity and mortality seen in patients with atrial fibrillation.
Authors: Jatinder S Minhas; Xia Wang; Pablo M Lavados; Tom J Moullaali; Hisatomi Arima; Laurent Billot; Maree L Hackett; Veronica V Olavarria; Sandy Middleton; Octavio Pontes-Neto; H Asita De Silva; Tsong-Hai Lee; Jeyaraj D Pandian; Gillian E Mead; Caroline Watkins; John Chalmers; Craig S Anderson; Thompson G Robinson Journal: J Hum Hypertens Date: 2019-03-20 Impact factor: 3.012
Authors: Gurpreet S Wander; Sinead T J McDonagh; M Srinivasa Rao; R Alagesan; J C Mohan; Ajit Bhagwat; A K Pancholia; M Viswanathan; Manoj Bhavrilal Chopda; A Purnanand; P L N Kapardhi; Arun R Vadavi; R Selvaraj; Pankaj Aneja; Suhas Hardas; Neil Bordoloi; N Sivakadaksham; Nilesh Goswami; Christopher E Clark; Willem J Verberk Journal: J Clin Hypertens (Greenwich) Date: 2022-07-10 Impact factor: 2.885