Noninvasive Evaluation of Central Haemodynamic Parameters

Abstract

Ageing is one of the relevant cardiovascular risk factors. Non-invasive assessment of cardiac function is an important approach in preventive medicine. The aim of our study was to evaluate the effect of age and gender on central haemodynamics. Seventy-six clinically healthy individuals were divided into four groups according to their age and gender. Applanation tonometry was applied using Sphygmocor device (AtCor, Australia). Pulse wave analysis was utilized for non-invasive assessment of central pressures (systolic, diastolic, mean, pulse, augmentation and end-systolic). Several important derivative indices such as augmentation index AIx75 $$(\frac{\rm Augmentation\ pressure}{\rm Pulse\ pressure}\times 100$$, corrected for heart rate 75 beats/minute), arterial elastance (Ea,$$\frac{\rm End - systolic\ pressure}{\rm Stroke\ volume})$$ and wasted effort (Ew) were computed. Ew is the ventricular force that is generated to overcome the late systolic peak and does not contribute to an increased stroke volume. Arterial stiffening was confirmed by the significantly higher central systolic and pulse pressures, AIx75 and arterial elastance in the middle-aged groups ($$P<0.01$$). Those alterations were most pronounced in middle-aged females in support to the concept for a postmenopausal effect of female gender beyond ageing. We have shown a positive correlation between Ew and Ea valid only for the middle-aged individuals ($$R=0.70$$, $$P<0.001$$) that coincided with similar correlation between Ea and AIx75 for the same age groups ($$R=0.53$$, $$P<0.001$$). Our supposition is that arterial stiffening contributes to the elevation of the `pulsatile' afterload thus impairing vascular/ventricular coupling and increasing myocardial load and oxygen demands. In conclusion, applanation tonometry and PWA provide reliable measures of central haemodynamics and myocardial afterload.