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Service de Physiologie et d'Explorations Fonctionnelles and Institut National de la Santé et de la Recherche Médicale (INSERM) U251, Centre Hospitalier Universitaire (CHU) Xavier Bichat, Assistance Publique-Hôpitaux de Paris, 75018 Paris; Service de Chirurgie Thoracique et Cardiovasculaire, CHU Henri Mondor, 94 010 Créteil; Service d'Explorations Fonctionnelles Cardiovasculaires et Respiratoires, CHU de Bicêtre, 94 275 Le Kremlin-Bicêtre Cedex; and INSERM U451, Loa-Ensta-Ecole Polytechnique, 91 761 Palaiseau Cedex, France
In heart transplant recipients (HTR), short-term systolic blood pressure variability is preserved, whereas heart rate variability is almost abolished. Heart period is the sum of left ventricular ejection time (LVET) and diastolic time (DT). In the present time-domain prospective study, we tested the hypothesis that short-term fluctuations in aortic pulse pressure (PP) in HTR were related to fluctuations in LVET. Seventeen male HTR (age 48 ± 6 yr) were studied 16 ± 11 mo after transplantation. Aortic root pressure was obtained over a 15-s period using a micromanometer both at rest (n = 17) and following the cold pressor test (CPT, n = 14). There was a strong positive linear relationship between beat-to-beat LVET and beat-to-beat PP in all patients at rest and in 13 of 14 patients following CPT (each P < 0.01). The slope of this relationship showed little scatter both at rest (0.34 ± 0.07 mmHg/ms) and following CPT (0.35 ± 0.09 mmHg/ms, P = not significant). Given the essentially fixed heart period, DT varied inversely with LVET. As a result, in 13 of 17 HTR at rest and in 12 of 14 HTR following CPT, there was a negative linear relationship between beat-to-beat PP and DT. In conclusion, our short-term time-domain study demonstrated a strong positive linear relationship between LVET and blood pressure variability in male HTR. We also identified a subgroup of HTR in whom there was a mismatch between PP and DT.
diastole; transplantation; blood pressure; stress; heart rate
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