The enhanced heart rate and blood pressure soon after awaking increases cardiac oxygen demand, and has been associated with the high incidence of acute myocardial infarction in the morning. The behavior of cardiac oxygen supply is unknown. We hypothesized that oxygen supply decreases in the morning and to that purpose investigated cardiac oxygen demand and oxygen supply at night and after awaking. We compared hypertensive to normotensive subjects and furthermore assessed whether pressures measured non-invasively and intraarterially give similar results. Aortic pressure was reconstructed from 24-h intra-brachial and simultaneously obtained non-invasive finger pressure in 14 hypertensives and 8 normotensives. Supply was assessed by Diastolic Time Fraction (DTF, ratio of diastolic and heart period), demand by Rate-Pressure Product (RPP, systolic pressure times heart rate, HR) and supply/demand ratio by Adia/Asys, with Adia and Asys diastolic and systolic areas under the aortic pressure curve. Hypertensives had lower supply by DTF and higher demand by RPP than normotensives during the night. DTF decreased and RPP increased in both groups after awaking. The DTF of hypertensives decreased less becoming similar to the DTF of normotensives in the morning; the RPP remained higher. Adia/Asys followed the pattern of DTF. Findings from invasively and non-invasively determined pressure were similar. The cardiacoxygen supply/demand ratio in hypertensive patients is lower than in normotensives at night. With a smaller nightday differences, the hypertensives’ risk for cardiovascularevents may be more evenly spread over the 24 h. This information can be obtained noninvasively.
Westerhof, B.E., Van Lieshout, J.J., Parati, G., Van Montfrans, G.A., Guelen, I., Spaan, J.A., et al. (2011). Cardiac oxygen supply is compromised during the night in hypertensive patients. MEDICAL & BIOLOGICAL ENGINEERING & COMPUTING, 49(9), 1073-1081 [10.1007/s11517-011-0810-7].
|Citazione:||Westerhof, B.E., Van Lieshout, J.J., Parati, G., Van Montfrans, G.A., Guelen, I., Spaan, J.A., et al. (2011). Cardiac oxygen supply is compromised during the night in hypertensive patients. MEDICAL & BIOLOGICAL ENGINEERING & COMPUTING, 49(9), 1073-1081 [10.1007/s11517-011-0810-7].|
|Tipo:||Articolo in rivista - Articolo scientifico|
|Carattere della pubblicazione:||Scientifica|
|Presenza di un coautore afferente ad Istituzioni straniere:||Si|
|Titolo:||Cardiac oxygen supply is compromised during the night in hypertensive patients|
|Autori:||Westerhof, BE; Van Lieshout, JJ; Parati, G; Van Montfrans, GA; Guelen, I; Spaan, JA; Westerhof, N; Karemaker, JM; Bos, WJ|
|Data di pubblicazione:||2011|
|Rivista:||MEDICAL & BIOLOGICAL ENGINEERING & COMPUTING|
|Digital Object Identifier (DOI):||http://dx.doi.org/10.1007/s11517-011-0810-7|
|Appare nelle tipologie:||01 - Articolo su rivista|
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