Comparison Of Peak Circulatory Power Between Normotensive And Hypertensive Individuals And Its Association With Central Hemodynamics And Carotid Remodeling

Circulatory Power (CircP) enhances the prognostic value of cardiopulmonary exercise test (CPET) in a wide range of cardiovascular and pulmonary diseases; however, it has been investigated only in specific ones. The differences in CircP between normotensive and hypertensive individuals, as well as its association with aortic stiffness (carotid-femoral pulse wave velocity, cfPWV), pressure wave reflections (augmentation index, AIx) and carotid remodeling (intimal-medial thickness, IMT), has not been investigated so far. PURPOSE: To test the hypotheses that CircP is higher in normotensive than in hypertensive individuals and, that CircP will be significantly associated with carotid remodeling. METHODS: Under standardized laboratory conditions using the Sphygmocor AtCor device having a built-in algorithm for pulse wave analysis, cfPWV and AIx were measured; left-ventricular mass and left/ right common carotid IMT were measured by ultrasound. A separated day CPET was performed and CircP was calculated as the product of peak oxygen consumption (VO2peak; mL O2·kg−1 ·min−1), derived from gas analyzer, and peak systolic blood pressure (peak SBP; mmHg), derived from another cuff-based recording device. All individuals conducted a breath-by-breath protocol on cycle ergometer. Linear regression analysis, t-test and adjustment for confounders were performed. RESULTS: Analysis was performed in 34 consecutive individuals (aged 54,63 ± 12,7; 67% men; 79% hypertensive; 88% dyslipidemic; 18% with type 1 diabetes; 3% patients with type 2 diabetes); normotensive had higher units of CircP than hypertensive (4333 ± 1920 versus 3193 ± 797), even after adjustment for confounders. CircP was found to depend considerably on age (0.004, p < 0.01), body mass index (0.028, p < 0.05). AIx (-0.005, p < 0,01), left and right IMT (-0.015, p < 0.05; -0.004, p < 0.01) were found to have significant correlation with CircP; no changes were observed after adjusting for confounders. CONCLUSIONS: CirP is higher in normotensive than in hypertensive individuals, and it is associated with carotid remodeling.