Pulse Wave Velocity as a Measure of Blood Pressure Change

Gribbin, B.; Steptoe, Andrew; Sleight, Peter

doi:10.1111/j.1469-8986.1976.tb03344.x

Cited by 204 publications

(98 citation statements)

References 23 publications

(20 reference statements)

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“…These changes were also clearly seen in the PTT/SBP slopes, which were used to estimate changes in SBP from changes in PTT. 29,30 Our data also indicated that about half of the changes with blood pressure were direct and were not mediated via an age effect. HR was only weakly associated with PTT, and for the ear site only.…”

Section: Discussionsupporting

confidence: 60%

Age-related changes in peripheral pulse timing characteristics at the ears, fingers and toes

2002

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It is accepted that older subjects have increasing arterial stiffness, which results in increasingly faster pulse transmission to the periphery. However, this age association is less clear in younger subjects and for different peripheral measurement sites. The aims of this study were to determine the association between age and pulse timing characteristics over a five decade age range at the ears, fingers and toes, and to compare these with any additional effects associated with differences in subject height, systolic blood pressure and heart rate. Photoplethysmography pulse waveforms were recorded noninvasively from the right and left sides at the ears, fingers and toes of 116 normal healthy human subjects. Their median age was 42 years (range 13-72 years). Systolic blood pressure, height and heart rate were also measured. Pulse transit times (PTTs) were determined and referenced to the electrocardiogram R wave. The results revealed that age was the strongest contributor to PTT differences at all sites (Po0.0001). The decrease with ageing was greatest at the toes: À1.6, À0.6, À0.4 ms/year for the toes, fingers, and ears, respectively. Changes for the right and left body sides at each level were highly similar. Blood pressure was also an important contributor to PTT at all sites (Po0.0001); À1.0, À0.4, À0.3 ms/ mm Hg, respectively, with approximately half of the effect explained by age. Height was significantly and independently related to PTT at the fingers and toes (Po0.0001); +1.1, +0.7 ms/cm, respectively. The fraction of PTT variability explained by these relationships was 0.65, 0.48, 0.26 for the toes, fingers and ears, respectively (Po0.0001). Finally, we concluded that the age effect decreased linearly from the second to the seventh decades, demonstrating that the effect of changes in arterial stiffness can be detected noninvasively from an early age at three main peripheral sites. Age is the dominant factor in contributing to PTT, and is greatest at the toes, followed by the fingers and then the ears.

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Section: Discussionsupporting

confidence: 60%

Age-related changes in peripheral pulse timing characteristics at the ears, fingers and toes

2002

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“…The Pulse transit time (PTT) and pulse arrival time (PAT) are promising non-invasive techniques for continuous blood pressure monitoring, particularly for detecting short-term perssure changes [7,8]. The PTT, defined as the the time delay for the pressure wave to travel between two arterial sites, and the PAT, defined as the interval between the R-wave in the ECG and a distal arterial pulse, are both negatively associated with blood pressure [9].…”

Section: Introductionmentioning

confidence: 99%

Pulse Arrival Time Accurately Detects Pacing-Induced Mechanical Alternans

Duijvenboden¹,

Child

Gill

et al. 2017

Computing in Cardiology Conference (CinC)

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Accurate cardiac risk stratification is crucial for preventing cardiac death, but still remains an unmet need. Mechanical alternans (MA), an oscillation of blood pressure that occurs on a beat-to-beat basis, has been recognized as a marker of cardiac instability and is associated with an increased risk of cardiac death. However, the use of MA for risk stratification is currently limited by the invasiveness and costs of continuous blood pressure monitoring. A non-invasive, cuffless and affordable method to detect MA is therefore highly desirable. The pulse transit time (PTT) and the pulse arrival time (PAT) are promising techniques for continuous blood pressure monitoring, particularly for detecting short-term blood pressure changes. In this work, we hypothesized that PAT, measured as the interval between the R-wave in the ECG and a distal arterial pulse, can be used to accurately track fast beat-to-beat blood pressure dynamics and detect MA. A total of 42 ECG and femoral arterial pressure recordings from 12 patients with normal ventricles were analyzed. Patients were instructed to breath at a fixed respiratory rate and MA was induced by ventricular pacing. Both MA and PAT alternans were detected using spectral analysis. MA was present in 69% of blood pressure recordings (n=29). ROC analysis showed that PAT accurately detected MA, with an area under the curve was equal to AUC = 0.94. The optimal threshold for detecting MA by using PAT provided 90% sensitivity and 85% specificity. In conclusion, this study demonstrates that PAT can be used to accurately detect pacing-induced MA and may represent a first step toward non-invasive, cuff-less and affordable MA screening for cardiac risk assessment.

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“…Importantly, this is in contrast to results from experiments using alternative techniques, which suggest that the increase in arterial stiffness in hypertensive individuals is largely because of the increase in mean pressure. 8,9 The 2 questions one must surely ask are, first, why do these findings seem to disagree with the findings of others using different methodology, and second, what relevance might these observations have from a clinical perspective?…”

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confidence: 95%

“…Previous work has either used pressure-compliance curves with interpolation of stiffness at a given blood pressure (BP) 8 or has normalized transmural pressure by placing the arm in a pressurized air chamber. 9 However, in this issue of Hypertension, Stewart et al 10 describe a method for generating isobaric conditions using a pharmacological intervention that acutely normalized the loading pressure in hypertensive subjects, dispensing with some of the assumptions associated with other methods. Stewart et al 10 studied 20 subjects with treated but inadequately controlled essential hypertension and 20 matched normotensive controls.…”

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confidence: 99%