Predictive regression equations and clinical uses of peripheral pulse timing characteristics in children

Abstract

Studies have shown that increased arterial stiffening can be an indication of cardiovascular diseases like hypertension. In clinical practice, this can be detected by measuring the blood pressure (BP) using a sphygmomanometer but it cannot be used for prolonged monitoring. It has been established that pulse wave velocity (PWV) is a direct measure of arterial stiffening but its usefulness is hampered by the absence of non-invasive techniques to estimate it. Pulse transit time (PTT) is a simple and non-invasive method derived from PWV. However, limited knowledge of PTT in children is found in the present literature. The aims of this study are to identify independent variables that confound PTT measure and describe PTT regression equations for healthy children. Therefore, PTT reference values are formulated for future pathological studies. Fifty-five Caucasian children (39 male) aged 8.4 +/- 2.3 yr (range 5-12 yr) were recruited. Predictive equations for PTT were obtained by multiple regressions with age, vascular path length, BP indexes and heart rate. These derived equations were compared in their PWV equivalent against two previously reported equations and significant agreement was obtained (p < 0.05). Findings herein also suggested that PTT can be useful as a continuous surrogate BP monitor in children.

Increased Pulse Wave Velocity and Blood Pressure in Children Who Have Undergone Cardiac Transplantation

“…16 As that study was based on timing of wave reflection, PWV was not given. Arterial stiffness has also been measured in children using other noninvasive methodologies, [17][18][19] and these may be useful for future research.…”

A Computational Approach to Predict Pulse Transit Time Variations During Postural Change

“…This degree of change in turn, is highly dependent on the instantaneous BP variations (Foo et al 2005a). As the BP increases, this affects the geometric and mechanical properties of the arterial wall thus, leading to an increase in its stiffness (Smith et al 1999;Pitson et al 1994;Li, 2004).…”

“…It had been demonstrated that postural change can cause notable changes in the arterial wall stiffness at the lower limbs only. Therefore, only BP changes can be observed at the lower limb when changes in hydrostatic pressure and gravitational forces occurred (Foo et al 2005a). The relationship between postural change and changes in pressure (or as DPTT in this study based on the known inverse correlation with BP changes) was demonstrated in the following postulate:…”

“…In order to assess the reliability of the computational model, data collected from a previous study were reused (Foo et al 2005a). This was a work that included 23 Caucasian children (19 male) with their mean age of 8.4 ± 2.3 years (range 5-12 years old).…”

“…It has been demonstrated that there is a significant change in DPTT during a postural change in a healthy child (Foo et al 2005a). Other studies have also demonstrated that the DPTT characteristics can be useful in the identification of vascular diseases and abnormalities at the lower limbs (Ahlstrom et al 2005;Sharwood-Smith et al 2006).…”