Association beween resting heart rate, shear and flow-mediated dilation in healthy adults

Preclinical data have demonstrated that heart rate (HR) can directly impact vascular endothelial function, in part, through a shear-stress mechanism. This study sought to explore, in humans, the associations between resting heart rate and both shear and endothelial function assessed by flow-mediated dilation (FMD). The brachial artery FMD test was performed in 31 apparently healthy volunteers. Basal (B) and hyperaemic (H) shear were quantified in the following two ways using data from the FMD test: the traditional cumulative shear area under the curve up to peak dilation (Shear_cum) method; and our novel method of shear summation (Shear_sum), which accounts for HR by summing each individual cardiac cycle shear up to peak dilation. Data were grouped by tertiles based on resting HR as follows: low (LHR = 43-56 beats min^-1; n = 10); middle (MHR = 58-68 beats min^-1; n = 11); and high (HHR = 69-77 beats min^-1; n = 10). Within the LHR group, both B-Shear_cum and H-Shear_cum were significantly higher (P < 0.001) than B-Shear_sum and H-Shear_sum, respectively, whereas in the HHR group B-Shear_cum and H-Shear_cum were significantly lower (P < 0.001) than B-Shear_sum and H-Shear_sum, respectively. The FMD in the LHR group (8.8 ± 0.8%) was significantly greater than that in both the MHR group (5.5 ± 0.8%; P = 0.009) and the HHR group (5.9 ± 0.8%; P = 0.024). These findings demonstrate the existence of a relationship between heart rate and both shear and endothelial function in humans. Moreover, these findings have implications for considering heart rate as an important physiological variable when quantifying shear and performing the FMD test.