PP.06.21] VOLUME-COMPRESSIVE OSCILLOMETRY IN NONINVASIVE ASSESSMENT OF HEMODYNAMIC PARAMETERS IN HYPERTENSIVE PATIENTS

Abstract

Objective: To evaluate hemodynamic parameters in patients with arterial hypertension (AH) before and during antihypertensive treatment using volume-compressive oscillometry (VCO) - new cuff-based device. The main advantages of VCO comparing to other oscillometry technic of BP registration is formation and recording the curve automatically in synchronism with the cuff inflation and recording the artery response by changing the cuff volume throughout the all period of cuff compression. VCO diagram could considered as indicator of aortic stiffness. Design and method: 45 untreated patients hospitalized with AH without acute coronary syndrome, severe valve problems, secondary hypertension, advanced chronic heart failure were enrolled. Mean age 55 ± 11.8 yrs, 51% male, mean BMI - 28.9 ± 6.7 kg/m2. Antihypertensive treatment included combination of amlodipine 5 mg/fosinopril 10 mg per day. The pulse wave velocity (PWV), brachial blood pressure (BP), cardiac index, stroke index and systemic vascular resistance were measured twice (at admission and discharging) by VCO (EDTV, Russia). Results: The mean systolic BP by VCO at admission was 147.7 ± 14.8 mmHg (by Korotkoff method 161 ± 9.8 mm Hg), diastolic 83.1 ± 14.1 mmHg (by Korotkoff method 99 ± 11.3 mmHg) and mean pulse pressure 64 ± 9.5 mmHg. Mean heart rate was 70.4 ± 14.5 bpm. Mean cardiac index was 3.08 ± 0.44 l/(min*m2), stroke index - 45.7 ± 11.7 ml/m2 and systemic vascular resistance (SVR) was 1373 ± 236 dyn*s/cm5. Mean PWV in these population was 7.6 ± 1.1 m/sec. After treatment with mean duration of hospitalization 6.3 ± 2.5 days, systolic and diastolic BP by VCO were reduced to 123.3 ± 10.8 mmHg and 57.5 ± 13.3 mmHg respectively (p < 0.05). Mean pulse pressure increased to 65.9 ± 11.8 mm Hg nonsignificantly. Mean stroke index increased to 49.7 ± 16.7 ml/m2 and SVR decreased to 1169 ± 374 dyn*s/cm5. We found no significant changes in cardiac index, heart rate and PWV. Conclusions: Systolic and diastolic BP by VCO is significantly lower comparing to Korotkoff method. Next studies are needed to determine the feasibility of VCO in noninvasive assessment of central hemodynamics.