Título

CHARACTERISTICS OF BRACHIAL PULSE PRESSURE AND PULSE WAVE VELOCITY IN ELDERLY INDIVIDUALS WITH ATRIAL FIBRILLATION: AN EVOPIU RETROSPECTIVE SUB-STUDY

Introdução

Parameters of arterial stiffness and pulse wave velocity (PWV) may be useful in improving the understanding of the mechanisms underlying the development and temporal evolution of atrial fibrillation (AF), and in facilitating clinical decisions regarding treatment. PWV and pulse pressure (PP) are two recognized biomarkers that could be used to determine arterial stiffness in the elderly. We hypothesized that the carotid-femoral PWV and brachial or central PP should not change in the presence of incident AF in the elderly.

Material e Método

Twenty-three patients from the Study of the PWV in Elderly Individuals in an urban area in Brazil (EVOPIU) with AF were followed-up for 3 years. In at least 1 annual medical visit, they were classified on the basis of AF diagnosis as with or without AF. Systemic blood pressure was obtained, and laboratory examinations, electrocardiography, and determination of carotid-femoral PWV were performed.

Resultados

Patients showed sinus rhythm in 28 medical visits and AF in 33 visits. From sinus rhythm to AF, the brachial PP decreased from 67.1 ± 23.7 to 56.9 ± 17.7 mmHg (P = 0.027), the central PP changed from 51.9 ± 21.5 to 44.4 ± 17.1 mmHg (P = 0.065), and the carotid femoral PWV did not show significant modifications (from 11.1 ± 3.3 to 10.1 ± 3.0 m/s; P = 0.116). Significant modifications were found in Period Heart rate, from 940 ± 236 to 829 ± 226 mms (P=0.032), and in P1 height, from 39.8 ± 15.5 to 34.0 ± 11.5 mmHg (P = 0.048).

Discussão e Conclusões

In patients who required biomarkers to monitor therapy effectiveness, such as elderly individuals with AF, brachial PP values changed during AF while the PWV remained unchanged in the same period. PP may not accurately represent vascular wall thickening when compared with carotid femoral PWV in elderly AF patients. Therefore, we suggest the use of PWV as a biomarker for monitoring therapies in cases where stiffness markers should be followed, such as during anti-coagulation therapy in patients with AF

Palavras Chave

atrial fibrillation; arterial stiffness; pulse pressure; pulse wave velocity