Pulse waveform analysis of arterial compliance: relation to other techniques, age, and metabolic variables

Resnick, Lawrence M.; Militianu, Daniela; Cunnings, Amy J.; Pipe, James G.; Evelhoch, Jeffrey L.; Soulen, Renata L.; Lester, Melvin A.

doi:10.1016/s0895-7061(00)01219-x

Cited by 94 publications

(42 citation statements)

References 27 publications

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“…15,16 The arterial distensibility, defined as the ratio of change of volume to the change in pressure (or the slope of the pressure volume curve), has been described as a marker for predicting vascular disease in previous studies. [17][18][19] The distensibility of both the large and small arterial systems serves as a cushion to buffer the pulsatile pressure and flow. A reduced buffering capacity leads to amplification of the reflected pressure waves and a more rapid PWV.…”

Section: Discussionmentioning

confidence: 99%

Assessment of Arterial Stiffness Index as a Clinical Parameter for Atherosclerotic Coronary Artery Disease

Seong

Seo

Lim

et al. 2005

Circ J

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Section: Discussionmentioning

confidence: 99%

Assessment of Arterial Stiffness Index as a Clinical Parameter for Atherosclerotic Coronary Artery Disease

Seong

Seo

Lim

et al. 2005

Circ J

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“…Using DPCA, C 1 was closely correlated to both the ratio of stroke volume (SV; determined non-invasively) to PP (SV/PP has been proposed as a measure of total arterial compliance, 101 and aortic distensibility measured by MRI, whereas C 2 correlated with SV/PP, but not aortic distensibility. 102 In a further study the correlation between stiffness parameters obtained by using SPCA, DPCA, and a third method that uses cuff plethysmography to measure brachial artery compliance was investigated. 103 Overall, different measures of compliance were only weakly correlated among themselves and with BP, although the cardiac time-tension index, the integral of the central pulse waveform from its beginning to the dichrotic notch, which is considered a measure of cardiac load, 104 was reasonably correlated with SBP and MAP.…”

Section: Comparison Of the Different Methodologiesmentioning

confidence: 99%

Noninvasive Assessment of Arterial Stiffness and Risk of Atherosclerotic Events

Oliver

Webb

2003

ATVB

731

563

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Abstract-Investigation of arterial stiffness, especially of the large arteries, has gathered pace in recent years with the development of readily available noninvasive assessment techniques. These include the measurement of pulse wave velocity, the use of ultrasound to relate the change in diameter or area of an artery to distending pressure, and analysis of arterial waveforms obtained by applanation tonometry. Here, we describe each of these techniques and their limitations and discuss how the measured parameters relate to established cardiovascular risk factors and clinical outcome. We also consider which techniques might be most appropriate for wider clinical application. Finally, the effects of current and future cardiovascular drugs on arterial stiffness are also discussed, as is the relationship between arterial elasticity and endothelial function. Arterial StiffnessData from the Framingham Heart Study have determined how systolic blood pressure (SBP), diastolic blood pressure (DBP) and pulse pressure (PP; the difference between SBP and DBP) change with advancing age. 1 DBP, largely determined by peripheral arterial resistance, increases until middle age and then tends to fall. In contrast, SBP and PP, influenced more by the stiffness of large arteries, as well as peripheral pulse wave reflection and the pattern of left ventricular ejection, increase continuously with age. Changes in the stiffness of the large arteries, such as the aorta and its major branches, largely account for the changes in SBP, DBP, and PP that occur from 50 years of age onward. Although DBP has traditionally been the major focus in the treatment of hypertension, over recent years SBP has become recognized as a stronger cardiovascular risk factor in older people. Thus, SBP has greater predictive value than DBP for coronary heart disease (CHD) in older people (Ͼ60 years). 2,3 Isolated systolic hypertension (ISH; SBP Ն140 mm Hg and DBP Ͻ90 mm Hg), is the most common subtype of hypertension in the middle aged and is overwhelmingly so in the elderly. 4 It is a major risk factor for stroke, 5 CHD, 2,3 and cardiovascular and total mortality. 6,7 Furthermore, measurement of SBP alone identifies Ͼ90% of hypertensives according to the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure VI criteria, whereas DBP alone identifies only Ϸ20%. 8 The treatment of ISH with conventional antihypertensive drugs is of proven clinical benefit. 9,10 However, although it is recognized that few hypertensives are controlled to target pressures, 11 it is much more commonly

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“…Noninvasive technology has enabled the measurement of pulse wave velocity and arterial pulse contour to assess vascular compliance (12,13). Doppler ultrasound has been used to measure pulsewave velocity and aortic compliance, but this method is operator-dependent and more prone to error (12).…”

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confidence: 99%

Vascular Compliance Is Reduced in the Early Stages of Type 1 Diabetes

Romney

Lewanczuk

2001

Diabetes Care

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OBJECTIVE -To determine whether arterial compliance of patients with type 1 diabetes is reduced before the development of clinically apparent diabetes complications.RESEARCH DESIGN AND METHODS -Pulse-wave analysis was used to compare vascular compliance between patients with type 1 diabetes and nondiabetic control subjects. Analysis of covariance was used to determine differences between the two groups with adjustment for age if needed.RESULTS -A total of 59 patients with type 1 diabetes were studied; age ranged from 17-61 years. Of the 59 patients, 32 had no evidence of diabetes complications and 27 had microvascular complications. The control group consisted of 57 healthy subjects ranging in age from 23-79 years. In the control group, large artery compliance (C1) and small artery compliance (C2) were inversely proportional to age (r ϭ Ϫ0.55 for C1 and Ϫ0.50 for C2; P Ͻ 0.01). When the control subjects were compared with type 1 diabetic patients without microvascular complications, C1 was 1.51 Ϯ 0.04 (SEM) for the control group and 1.33 Ϯ 0.06 (SE) ml/mmHg for the diabetic group, whereas C2 was 0.080 Ϯ 0.005 (SE) and 0.065 Ϯ 0.005 (SE) ml/mmHg for the control and diabetic subjects, respectively, when adjusted for age (P ϭ 0.03 for both C1 and C2).CONCLUSIONS -Vascular compliance of both the large and small arteries is reduced in type 1 diabetic patients before any clinical complications from the diabetes are evident. This study serves to emphasize that vascular changes occur at an early point in the disease and may increase risk of cardiovascular events in patients with diabetes. Larger prospective studies are required to confirm this finding and to investigate the efficacy of medical intervention. Diabetes Care 24:2102-2106, 2001H ypertension, hypercholesterolemia, and diabetes are well-recognized cardiovascular risk factors (1). Emerging evidence suggests that decreased vascular elasticity and storage capacity of the vessels, also known as vascular compliance, is associated with each of these conditions and may predispose patients to cardiovascular events (2,3). A reduction in arterial compliance is a marker for vascular disease and should prompt a more aggressive approach in managing cardiovascular risk factors (3-6). Several studies have demonstrated diminished arterial compliance in patients with type 1 or type 2 diabetes, which may contribute, in part, to the excess cardiovascular morbidity and mortality associated with these conditions (7-11).Noninvasive technology has enabled the measurement of pulse wave velocity and arterial pulse contour to assess vascular compliance (12,13). Doppler ultrasound has been used to measure pulsewave velocity and aortic compliance, but this method is operator-dependent and more prone to error (12). In addition, Doppler techniques only assess large arteries because measurements are taken from the aorta or the aorta-iliac junction (12). Pulse-wave contour analysis is a reproducible and objective method for determining compliance of both the large and small arteries by using...

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Pulse waveform analysis of arterial compliance: relation to other techniques, age, and metabolic variables

Cited by 94 publications

References 27 publications

Assessment of Arterial Stiffness Index as a Clinical Parameter for Atherosclerotic Coronary Artery Disease

Assessment of Arterial Stiffness Index as a Clinical Parameter for Atherosclerotic Coronary Artery Disease

Noninvasive Assessment of Arterial Stiffness and Risk of Atherosclerotic Events

Vascular Compliance Is Reduced in the Early Stages of Type 1 Diabetes

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