Characteristics of Harmonic Indexes of the Arterial Blood Pressure Waveform in Type 2 Diabetes Mellitus

Abstract

Type 2 diabetes mellitus (T2DM) is an important public health issue worldwide. T2DM correlates with cardiovascular disease. Arterial stiffness is also a key factor that can be thought of as a surrogate marker. Nevertheless, it was unclear which harmonic indexes of blood pressure waveforms (BPWs) from subjects' radial artery pulses would be affected by T2DM. Therefore, the objective of this study was to investigate whether and how harmonic indexes can be used to discriminate hemodynamic differences between patients with T2DM and non-T2DM. This helps us to build objective results no matter who conducts the examination instead of pulse diagnosis in traditional way. We enrolled T2DM and non-T2DM patients as experimental and control groups, respectively, from the Department of Family Medicine in the National Taiwan University Hospital and the Department of Internal Medicine in Taipei's Veterans General Hospital from December 2017 to January 2019. ANSWatch® Model TS-0411 was used to capture the BPWs. Amplitude proportions (C n values) were calculated from harmonics 1–10 of the BPW using fast Fourier transform. Thirty-two T2DM and 15 non-T2DM patients were enrolled. T2DM patients had significant differences in C 1 ( p = 0.031) and C 5 ( p = 0.041). The study suggests that analyzing the harmonic characteristics of non-invasively measured BPW of radial artery may be a potential and easy-to-perform approach to discriminate T2DM-induced hemodynamic changes.

A First Step towards a Comprehensive Approach to Harmonic Analysis of Synchronous Peripheral Volume Pulses: A Proof-of-Concept Study

“…In addition, we established a five-step HA computation formula for the peripheral volume pulse, described in Section 2.3.2. Hence, the current study obtained results for type 2 diabetes mellitus [14][15][16][17]. It has been reported that the fourth harmonic component of the radial pulse wave is important for the risk assessment of macrovascular and microvascular events in patients with type 2 diabetes [14], cardiovascular risk [15], and arterial blood pressure waveforms [16], with different radial pulse wave harmonic indices, silent coronary artery disease, and adverse cardiac events [17].…”

“…It has been reported that the fourth harmonic component of the radial pulse wave is important for the risk assessment of macrovascular and microvascular events in patients with type 2 diabetes [14], cardiovascular risk [15], and arterial blood pressure waveforms [16], with different radial pulse wave harmonic indices, silent coronary artery disease, and adverse cardiac events [17]. Therefore, our findings for synchronous peripheral volume pulses are consistent with the findings in [14][15][16][17], in which the radial pulse wave was adopted with different harmonic coefficients.…”

“…Professors Tsai et al indicated that the harmonic characteristics of the radial artery in the wrist at different positions and different parameters were not identical, and recommended that any measurement location in future studies on the HA of pressure pulse diagnosis needs a more finely adjusted analysis [10]. More importantly, there have been further studies about the HA of radial arterial waveform (e.g., a kind of peripheral pressure pulse) addressing hypertension [11] and monitoring applied to coronary artery disease [12], type 2 diabetes mellitus [13][14][15][16], and the preservation of health [17]. On the other hand, a noninvasive wearable MEMS pressure sensor array was proposed in [18] for monitoring the arterial pulse waveform and heart rate, and the detection of atrial fibrillation.…”

On non-Kolmogorov turbulence in blood flow and its possible role in mechanobiological stimulation

“…The heart, as a positive displacement pump, drives arterial flow by a multiharmonic pressure waveform that is known to correlate with physiologic and pathologic processes and conditions 1 – 4 . Downstream from the heart, as blood flows through the anatomically sophisticated arterial network 5 , it exhibits complex hemodynamic features such as coherent structures 6 , helical flow (i.e.…”

On Non-Kolmogorov turbulence in blood flow and its possible role in mechanobiological stimulation

“…The heart, as a positive displacement pump, drives arterial flow by a multiharmonic pressure waveform that is known to correlate with physiologic and pathologic processes and conditions [1][2][3][4] . Downstream from the heart, as blood flows through the anatomically sophisticated arterial network 5 , it exhibits complex hemodynamic features such as coherent structures 6 , helical flow (i.e.…”