A Comparative Study of Methods of Measurement of Peripheral Pulse Waveform

  • Kang, Hee-Jung (R&D Center, DAEYOMEDI Co. Ltd., Ansan, KOREA) ;
  • Lee, Yong-Heum (Department of Biomedical Engineering, Yonsei University) ;
  • Kim, Kyung-Chul (Department of Diagnostic, College of Oriental Medicine, Dong-Eui University) ;
  • Han, Chang-Ho (Department of Internal Medicine, College of Oriental Medicine, Dongguk University)
  • Published : 2009.05.30

Abstract

Objective: Increased aortic and carotid arterial augmentation index (AI) is associated with the risk of cardiovascular disease. The most widely used approach for determining central arterial AI is by calculating the aortic pressure waveform from radial arterial waveforms using a transfer function. But how the change of waveform by applied pressure and the pattern of the change rely on subject's characteristics has not been recognized. In this study, we use a new method for measuring radial waveform and observe the change of waveform and the deviation of radial AI in the same position by applied pressure. Method: Forty-six non-patient volunteers (31 men and 15 women, age range 21-58 years) were enrolled for this study. Informed consent in a form approved by the institutional review board was obtained in all subjects. Blood pressure was measured on the left upper arm using an oscillometric method, radial pressure waves were recorded with the use of an improved automated tonometry device. DMP-3000(DAEYOMEDI Co., Ltd. Ansan, Korea) has robotics mechanism to scan and trace automatically. For each subject, we performed the procedure 5 times for each applied pressure level. We could thus obtain 5 different radial pulse waveforms for the same person's same position at different applied pressures. All these processes were repeated twice for test reproducibility. Result: Aortic AI, peripheral AI and radial AI were higher in women than in men (P<0.01), radial AI strongly correlated with aortic AI, and radial AI was consistently approximately 39% higher than aortic AI. Relationship between representative radial AI of DMP-3000 and peripheral AI of SphygmoCor had strongly correlation. And there were three patterns in change of pulse waveform. Conclusion: In this study, it is revealed the new device was sufficient to measure how radial AI and radial waveform from the same person at the same time change under applied pressure and it had inverse-proportion to applied pressure.

Keywords

References

  1. Nichols WW, O’Rourke MF: McDonald’s Blood Flow in Arteries. Theoretical, Experimental and Clinical Principles. Fourth Edition. Edward Arnold, London, 1998, pp 201-2.
  2. Nichols WW, O’Rourke MF: McDonald’s Blood Flow in Arteries. Theoretical, Experimental and Clinical Principles. Fourth Edition. Edward Arnold, London, 1998, pp 201-2.
  3. Weber T, Auer J, O’Rourke MF, Kvas E, Lassnig E, Berent R, Eber B. Arterial stiffness, wave reflections, and the risk of coronary artery disease. Circulation. 2004;109(2):184-9. https://doi.org/10.1161/01.CIR.0000105767.94169.E3
  4. London GM, Blacher J, Pannier B, Guérin AP, Marchais SJ, Safar ME. Arterial wave reflections and survival in end-stage renal failure. Hypertension. 2001;38(3):434-8. https://doi.org/10.1161/01.HYP.38.3.434
  5. Weber T, Auer J, O’Rourke MF, Kvas E, Lassnig E, Lamm G, et al. Increased arterial wave reflections predict severe cardiovascular events in patients undergoing percutaneous coronary interventions. Eur Heart J. 2005;26(24):2657-63. https://doi.org/10.1093/eurheartj/ehi504
  6. Kohara K, Tabara Y, Oshiumi A, Miyawaki Y, Kobayashi T, Miki T. Radial augmentation index: a useful and easily obtainable parameter for vascular aging. Am J Hypertens. 2005;18(1):11S-14S.
  7. Nichols WW, Singh BM. Augmentation index as a measure of peripheral vascular disease state. Curr Opin Cardiol. 2002;17(5):543-51. https://doi.org/10.1097/00001573-200209000-00016
  8. O’Rourke MF, Mancia G. Arterial stiffness. J Hypertens. 1999;17(1):1-4. https://doi.org/10.1097/00004872-199917010-00001
  9. Hayashi T, Nakayama Y, Tsumura K, Yoshimaru K, Ueda H. Reflection in the arterial system and the risk of coronary heart disease. Am J Hypertens.2002;15(5):405-9. https://doi.org/10.1016/S0895-7061(02)02260-4
  10. Chen CH, Nevo E, Fetics B, Pak PH, Yin FC, Maughan WL, et al. Estimation of central aortic pressure waveform by mathematical transformation of radial tonometry pressure. Validation of generalized transfer function. Circulation 1997;95(7):1827-36. https://doi.org/10.1161/01.CIR.95.7.1827
  11. Hope SA, Tay DB, Meredith IT, Cameron JD. Use of arterial transfer functions for the derivation of aortic waveform characteristics. J Hypertens. 2003;21(7):1299-305. https://doi.org/10.1097/00004872-200307000-00017
  12. Lee J, Lee YJ, Jeon YJ, Lee HJ. An example of test on differences of pulse waveform characteristics at Cun, Guan and Chi. J Korean Oriental Med. 2008;14(2):107-12.
  13. Lee JW. A study on the waveform analysis of radial artery pulse diagnosis using pulse meter and analyzer. Dong-Eui University Doctor’s thesis. 2008.12.
  14. Ryu KH. A study on the waveform analysis of radial artery pulse diagnosis. Dong-Eui University Doctor’s thesis. 2008.12.