Noninvasive evaluation of varying pulse pressures in vivo using brachial sphymomanometry, applanation tonometry, and Pulse Wave Ultrasound Manometry

Abstract

The routine assessment and monitoring of hypertension may benefit from the evaluation of arterial pulse pressure (PP) at more central locations (e.g. the aorta) rather solely at the brachial artery. Pulse Wave Ultrasound Manometry (PWUM) was previously developed by our group to provide direct, noninvasive aortic PP measurements using ultrasound elasticity imaging. Using PWUM, radial applanation tonometry, and brachial sphygmomanometry, this study investigated the feasibility of noninvasively obtaining direct PP measurements at multiple arterial locations in normotensive, pre-hypertensive, and hypertensive human subjects. Two-way ANOVA indicated a significantly higher aortic PP in the hypertensive subjects, while radial and brachial PP were not significantly different among the subject groups. No strong correlation (r2 < 0.45) was observed between aortic and radial/brachial PP in normal and pre-hypertensive subjects, suggesting that increases in PP throughout the arterial tree may not be uniform in relatively compliant arteries. However, there was a relatively strong positive correlation between aortic PP and both radial and brachial PP in hypertensive subjects (r2 = 0.68 and 0.87, respectively). PWUM provides a low-cost, non-invasive, and direct means of measuring the pulse pressure in large central arteries such as the aorta. When used in conjunction with peripheral measurement devices, PWUM allows for the routine screening of hypertension and monitoring of BP-lowering drugs based on the PP from multiple arterial sites.

Bioinspired Microstructured Pressure Sensor Based on a Janus Graphene Film for Monitoring Vital Signs and Cardiovascular Assessment

“…To monitor the pulse wave, pressure sensors are attached at a suitable place on the neck, arm, and wrist by medical tape to monitor the aorta, brachial, and radial arteries, respectively (inset of Figure a). As shown in Figure a, periodic pulse waveforms are acquired from the corresponding locations, indicating typical waveforms for the aorta and radial arteries . The aortic pulse waveforms also exhibit representative points, from which three parameters including round‐trip travel time, systolic duration, and the aortic augmentation index can be extracted (Figure S13, Supporting Information) .…”

“…As shown in Figure 4a, periodic pulse waveforms are acquired from the corresponding locations, indicating typical waveforms for the aorta and radial arteries. [26,27] The aortic pulse waveforms also exhibit representative points, from which three parameters including round-trip travel time, Figure 3. a) Schematic illustration of the pressure sensor for monitoring human vital signs.…”

Ultrasound Time-Harmonic Elastography of the Aorta

“…Other studies investigating biomechanical changes of vessel wall due to age and hypertension have included between 8 and 30 participants in ultrasound studies and between 8 and 21 participants in MRE studies. 17,18,21,23,24,27 Participants Inclusion criteria for healthy participants were an age of at least 18 years and absence of cardiovascular risk factors (ie, arterial hypertension, hyperlipidemia, diabetes, active smoking, and/or obesity with a body mass index >30 kg/m 2 ). Inclusion criteria for patients were a history of hypertension and current intake of antihypertensive medication.…”

Analysis of the Radial Pulse Wave and its Clinical Applications: A Survey

“…The other method is to optimize the quality of the pressure and flow waveform of arteries through local pulse wave velocity (PWV) using ultrasound imaging. Li et al measured aortic waveform through ultrasound imaging to correct pressure, and demonstrated that the peak of the forward wave of the radial pulse wave was related to the inflection point of aortic pulse wave in the healthy subjects and prehypertension patients, which represented the beginning of pressure increase [24].…”

“…With the development of sensor technologies, flexible sensors have been used to record radial pulse waves [17,18]. In addition, some researchers have employed multi-sensor fusion methods including multichannel signal fusion [19][20][21][22][23][24], and array signal fusion [20,[25][26][27], to obtain rich information related to the cardiovascular system from radial pulse waves. However, comprehensive analysis of radial parameters, morphological changes, and clinical applications has not been reported.…”