Daily monitoring of pulse transit time for estimation of main arteries stiffness parameters after receiving 16-week carvedilol therapy

Oleynikov V.E., Gusakovskaya L.I.
Medical institute PGU

Introduction (Purpose/tasks):
Evaluation of clinical effectiveness and indices dynamics characterizing arterial stiffness while patients with metabolic syndrome were receiving 16-week carvedilol therapy (Carvetrend, “Pilva”).

Materials and methods:
20 patients with arterial hypertension I-II degree in metabolic syndrome (9 male and 11 female), of the average age 48,59 ± 9,35 years were inspected. While choosing patients with metabolic syndrome there were used VNOK-recommendations (2007). Research was conducted after two-week “washing off” period. Arterial stiffness was defined with the use of bifunctional ambulatory blood pressure and ECG monitor BPLab Advanced (OOO “Petr Telegin”, Russia). Such indices as pulse transit time (PTT), dP/tmax, ASI-index, Ssys were determined. Patients were monitored before treatment and within carvedilol treatment period, the average dose was 27,14 ± 9,3 mg/day.

Results:
After 16-week drug treatment PTT-index increased from 129,16 ±  12,12 ms to 136,22 ± 10,59 ms (p<0,01), dP/dtmax index decreased from 597,85 ± 87,08 mmHg/s to 541,25 ± 59,08 mmHg/s (p<0,01). A reliable decrease of stiffness index was registered: from 155,83 ± 22,59 mmHg to 146,4 ± 25,0 mmHg, and decrease of Ssys-index from 56,82 ± 4,57% to 54,08 ± 4,57% (p<0,01) either.

Conclusion: Increase of vascular stiffness is an independent predictor of cardiovascular disease incidence and mortality. Carvedilol therapy showed a reliable improvement of vascular structure parameters and function. In such a way a daily PTT monitoring can be used for estimation of main arteries vascular remodeling.