The associations of cardiac structure and function with blood pressure at rest and during exercise
Objective:To investigate whether exercise blood pressure (BP) was associated with cardiac structure and function independent of BP at rest.Methods:In the outpatients who underwent non-invasive cardiac exercising test and echocardiography at The First Affiliated Hospital of Sun Yat-Sen University between January 2019 and October 2020, collected the clinical data and retrospectively assessed the association of cardiac structure (i.e., left atrial internal diameter, interventricular septal wall thickness, left ventricular posterior wall thickness), diastolic function [i.e., the peak early-diastolic (E) and peak end-diastolic (A) transmission velocity, the mean early-diastolic myocardial velocity (e')], and systolic function (left ventricular ejection fraction) with 1-SD increment in BP during exercise and at rest, using multivariable regression analyses.Results:Among the 323 participants, age averaged (46.2±15.1) years. 40.2% (130/323) were men, and 13.6% (44/132) had coronary heart disease. With adjustments applied for gender, age, body mass index, coronary heart disease, and BP at rest, the association sizes with 1-SD increase in exercise systolic, and diastolic BP were 0.33 mm (P<0.001) / 0.33 mm (P<0.001) for interventricular septal wall thickness, and 0.32 mm (P<0.001) / 0.24 mm (P=0.004) for left ventricular posterior wall thickness, while the association sizes were non significant for the associations between indices of cardiac function and exercise systolic BP. After adjusted for gender, age, body mass index, coronary heart disease, and exercise BP, the association sizes with 1-SD increase in systolic BP at rest were 3.93 mm/s (P<0.001) for A peak and 0.46 (P=0.002) for E/e'. The association sizes with 1-SD increase in diastolic BP at rest were 2.91 mm/s (P=0.005) for A peak and -0.08 (P=0.002) for E/A, and 1-SD increase in systonic BP at rest were 0.26 mm for IVST (P=0.007), while there were no associations between indices of cardiac structure and systolic BP at rest with exception for interventricular septal wall thickness. After accounted for potential confounders, there was no association of left ventricular ejection fraction with BP during exercise and at rest.Conclusion:Exercise BP was mainly associated with cardiac structure independent of BP at rest, while BP at rest was mainly correlated with cardiac diastolic function independently of exercise BP.
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