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European Heart Journal 1995 16(4):545-552;
Copyright © 1995 by the European Society of Cardiology.
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© 1995 The European Society of Cardiology

The mechanism of blood pressure variability

Study in patients with fixed ventricular pacemaker rhythm

A. KARDOS*,, L. RUDAS{dagger}, Z. GINGL{ddagger}, S. SZABADOS§ and J. SIMON

*Second Department of Medicine, Albert Szent-Gyorgyi Medical University Szeged, Hungary
{dagger}Department of Internal Intensive Medicine, Albert Szent-Gyorgyi Medical University Szeged, Hungary
§Department of Cardiac Surgery, Albert Szent-Gyorgyi Medical University Szeged, Hungary
{ddagger}Department of Experimental Physics, Attila József University Szeged, Hungary

revised 29 August 1994; accepted 22 September 1994.

Attila Kardos, MD, Second Department of Medicine, Albert Szent-Gyorgyi Medical University, H-6721 Szeged, Korányi fasor 6, Hungary.

Abstract

Background: Several studies have shown that heart rate variability plays an anti-oscillatory role in the regulation of blood pressure variability in humans. We tested whether systolic blood pressure variability in patients with a fixed ventricular pacemaker rhythm differs from that in patients with sinus rhythm.

Methods and Results: In 18 patients with a fixed ventricular pacemaker rhythm and in ten age-matched patients with sinus rhythm the systolic blood pressure oscillation and the low and high-frequency spectral components of systolic blood pressure were studied in the resting supine position during spontaneous breathing and during forced deep ventilation of 6 cycles. min–1. Patients with a pacemaker had a higher amplitude of systolic blood pressure oscillation than control subjects during spontaneous breathing (13.5 ± 2.0 mmHg vs 6.4 ± 1.6 mmHg, P=0.035), and a slight but not significant difference also persisted during forced deep ventilation (19.0 ± 2.3 mmHg vs 15.0 ± 2.3 mmHg, P=0.18). The increment in systolic blood pressure fluctuation from spontaneous breathing to forced deep ventilation was less marked in the pacemaker group than in the control subjects (40% vs 130%, P=0.43). Although all the systolic blood pressure spectral components of the pacemaker patients were higher during both spontaneous breathing and forced deep ventilation, the differences between the two groups did not reach statistical significance.

Conclusions: Our observations in patients with a fixed ventricular pacemaker rhythm suggest that the mechanical effects on the intrathoracic vessels and the consecutive stroke volume changes are responsible for respiration-related systolic blood pressure oscillation and reflex systolic blood pressure changes.

Key Words: Blood pressure spectral analysis • fixed ventricular pacemaker rhythm • human study


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