The Effects of Traditional Dual Chamber Cardiac Permanent Pacemaker on Arterial Distensibility Using Carotid- Femoral (Aortic) Pulse Wave Velocity in Patients with Angiographically Normal Coronary Arteries

Abstract

Introduction: The traditional dual chamber cardiac permanent pacemakers are widely used for symptomatic bradycardia. Pulse wave velocity (PWV) is an index of arterial stiffness and a marker of cardiovascular events. This study aims to investigate arterial distensibility using carotidfemoral (aortic) PWV measurements in patients with traditional dual chamber cardiac permanent pacemakers and angiographically normal coronary arteries. Patients and Methods: We recruited 17 paced patients and 17 age and sex matched controls. Aortic PWV was determined using an automatic device, the Complior Colson (France), which allowed on-line pulse wave recording and automatic calculation of PWV. PWV is calculated from measurements of pulse transit time and the distance travelled by the pulse between two recording sites, according to the following formula: PWV (m/s) = Distance (m) / Transit time (s) Results: The carotid-femoral PWV (10.20 ± 2.00, 9.06 ± 0.94 m/s, p= 0.04) was increased in patients with dual chamber pacing as compared with age and sex-matched control group. Multiple regression analysis between PWV and clinical parameters (age, sex, weight, height, systolic blood pressure, diastolic blood pressure, pulse pressure, mean blood pressure, heart rate) showed that PWV correlated positively with age (r2= 0.31; p= 0.007). Similar results were obtained in the paced patients (age, r2= 0.36; p= 0.03) and control (age, r2= 0.33; p= 0.04) subgroups when analyzed separately. Conclusion: Arterial distensibility is increased in patients with traditional dual chamber cardiac permanent pacemakers and angiographically normal coronary arteries, as compared with age and sex matched controls

Keywords

• Angiography; pacemaker, artificial; blood pressure; carotid arteries; vascular stiffness.

Klasik Çift Odacıklı Kalıcı Kalp Pilinin Anjiyografik Olarak Normal Koroner Arterleri Olan Hastalarda Karotis-Femoral (Aortik) Nabız Dalga Hızı Aracılığıyla Ölçülen Arteriyel Distansibilite Üzerine Etkileri

Abstract

Giriş: Klasik çift odacıklı kalıcı kalp pili semptomatik bradikardide geniş bir şekilde kullanılmaktadır. Nabız dalga hızı (NDH) arteriyel sertleşmenin bir indeksi ve kardiyovasküler olayların bir belirtecidir. Bu çalışmanın amacı, klasik çift odacıklı kalıcı kalp pili ve anjiyografik olarak normal koroner arterleri olan hastalarda karotis-femoral (aortik) NDH aracılığıyla arteriyel distansibiliteyi araştırmaktır. Hastalar ve Yöntem: Çalışmaya 17 kalp pili hastası ile cinsiyet ve yaş yönünden uyumlu 17 kontrol grubu alındı. Aortik NDH, online nabız dalgası kaydeden otomatik Complior Colson (Fransa) cihazıyla belirlenip otomatik olarak hesaplandı. NDH, nabzın ilerlediği iki kaydedici bölge arasındaki mesafenin nabız geçiş zamanına oranı olarak; "NDH (m/s) = Mesafe (m) / Geçiş zamanı (s)" formülü ile hesaplandı. Bulgular: Karotis-femoral NDH (10.20 ± 2.00, 9.06 ± 0.94 m/s, p= 0.04) cinsiyet ve yaş yönünden uyumlu kontrol grubu ile karşılaştırıldığında, çift odacıklı kalp pili bulunan hastalarda daha yüksekti. NDH ve klinik değişkenler (yaş, cinsiyet, vücut ağırlığı, boy, sistolik kan basıncı, diyastolik kan basıncı, nabız basıncı, ortalama kan basıncı, kalp hızı) arasında çoklu regresyon analizi yapıldığında NDH ile yaş arasında pozitif ilişki gözlendi (r2= 0.31; p= 0.007). Alt grup analizi yapıldığında benzer sonuçlar kalp pili bulunan hastalarda (yaş, r2= 0.36; p= 0.03) ve kontrol grubunda (yaş, r2= 0.33; p= 0.04) da izlendi. Sonuç: Arteriyel distansibilite, klasik çift odacıklı kalıcı kalp pili ve anjiyografik olarak normal koroner arterleri olan hastalarda, yaş ve cinsiyet yönünden benzer kontrollere göre daha yüksektir.

Keywords

• Anjiyografi; kalp pili, yapay; kan basıncı; karotid arter; vasküler sertlik.

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