Author + information
- Daniel Duprez,
- Lynn Steffen,
- Lyndia C. Brumback,
- Otto Sanchez,
- Carmen Peralta,
- Julio Chirinos Medina,
- Andres Belalcazar,
- Peter Hannan,
- Joel Kaufman,
- Matthew Budoff,
- James Stein and
- David Jacobs
ECG R-wave to Radial Artery Pulse Delay (RRD) is a novel hemodynamic index obtainable from a single tonometric measurement with simultaneous ECG to assess the timing of an electrical marker (ECG R-wave peak) until a corresponding mechanical feature (end diastole at the radial pulse). We studied the cross-sectional association between RRD, prevalence of metabolic syndrome and coronary artery calcium score (CAC) in the MESA study. RRD comprises electromechanical delay, isovolumic contraction time and pulse transit time between the aorta and the radial artery (a time determined by the average arterial pulse wave velocity).
Radial artery tonometry was performed for 30 seconds in 3929 participants: female 53%; 40% white, 27% African-American, 21% Hispanics and 12% Chinese. RRD was calculated as the median across beats of the delay from the peak R-wave until the start of the systolic upstroke of the radial artery pulse waveform. The analytic variable was the residual of RRD (msec) in linear regression, given transit path length (cm). Linear regression, adjusted for age, race, sex, height, and transit path length, estimated mean blood pressure (BP), presence of the metabolic syndrome, and CAC Agatston score across RRD.
Women had higher RRD. Age, BP, metabolic syndrome prevalence, and geometric mean CAC score were all lower with greater RRD (Table).
RRD associated with cardiovascular risk factors and CAC. RRD is simple to apply and may be useful in cardiovascular studies.
|RRD (msec) range||70.0–107.4||107.5–115.1||115.2–121.6||121.7–128.5||128.6–137.2||137.3–231.1|
|Systolic BP (mmHg)||130.7||126.8||125.7||124.0||119.8||119.1||<0.001|
|Diastolic BP (mmHg)||69.8||69.8||69.2||68.3||66.7||66.4||<0.001|
|Metabolic Syndrome (%)||30.8||30.2||25.4||27.2||25.2||23.0||0.01|
|CAC score (geometric mean)||40.1||27.4||28.2||26.2||20.3||21.5||<0.001|
Poster Sessions, Expo North
Monday, March 11, 2013, 9:45 a.m.-10:30 a.m.
Session Title: Preclinical Manifestations of Hypertension and Arterial Stiffness
Abstract Category: 25. Prevention: Hypertension
Presentation Number: 1276-23
- 2013 American College of Cardiology Foundation