Risk assessment of macrovascular and microvascular events in patients with type 2 diabetes by analyzing the amplitude variation of the fourth harmonic component of radial pulse wave

Liao, Kuo‐Wei; Chang, Chi-Wei; Wang, Sheng-Hung; Chang, Yi-Ting; Chen, Ying‐Chun; Wang, Gin-Chung

doi:10.14814/phy2.14252

Cited by 9 publications

(3 citation statements)

References 33 publications

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“…6 The results also demonstrate that C4CV is independently and positively correlated with macrovascular and microvascular events. 7 Macrovascular events combined the major adverse cardiovascular events, coronary artery disease and severe peripheral artery disease. Microvascular events combined the major adverse kidney events, macroalbuminuria, retinopathy and polyneuropathy.…”

Section: Assessment Of Cardiovascular Risk In Type 2 Diabetes Patientmentioning

confidence: 99%

Assessment of cardiovascular risk in type 2 diabetes patients by insight into radial pulse wave harmonic index

Liao

Chang²,

Wang³

et al. 2019

Acta Physiologica

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Wang Lin provides an insightful explanation as to why the harmonic components of radial pulse waves may be an important set of signs to reveal the state of the ventricular-arterial system. 1 The important basis of the article comes from the "resonance theory" proposed by Wang et al through a series of elegant animal studies. 2,3 Here, we would like to provide further clinical references to point out the important correlation between the harmonic components of the radial pulse wave and the risk of future cardiovascular events.In 2017, we initiated an observational cohort study of RPWT2DM (IRB number: ISRCTN14306167) for cardiovascular risk assessment in patients with type 2 diabetes using radial pulse measurements. We found that the first harmonic amplitude (C1), the second harmonic phase (P2) and the variation coefficient of fourth harmonic amplitude (C4CV) of radial pulse wave are related to cardiovascular risk. The first cross-sectional survey showed that patients with more than 5% of ischaemic myocardium had higher C1 and C4CV than those without myocardial ischaemia. 4 In this cross-sectional study, we also found that patients with a left ventricular ejection fraction of less than 50% had higher C1, higher C4CV and lower P2 compared to patients with normal cardiac function. After a mean of 1.8 years of follow-up, we found a clearer association between these indicators and the risk of cardiovascular events. Cox proportional hazards model demonstrated that C1 is an independent predictor for major adverse cardiovascular events, 5 cardiovascular mortality 6 and microvascular events. 6 The results also demonstrate that C4CV is independently and positively correlated with macrovascular and microvascular events. 7 Macrovascular events combined the major adverse cardiovascular events, coronary artery disease and severe peripheral artery disease. Microvascular events combined the major adverse kidney events, macroalbuminuria, retinopathy and polyneuropathy. In addition, we demonstrate that lower quartile levels of P2 values can independently predict an increased risk of macrovascular and microvascular outcomes. 8 Based on the above studies, we determined three harmonic characteristics (C1 > 1.07, C4CV > 13% and P2 < 3.54) with high cardiovascular risk. In the RPWT2DM study, 556 (24%), 270 (12%) and 119 (5%) type 2 diabetic patients respectively, had 1, 2 and 3 cardiovascular risk-related harmonic characteristics as described above. One thousand three hundred and seventy-nine (59%) of those patients did not have any of the above harmonic characteristics. We performed a Cox proportional hazard model to determine the hazard ratios (HRs) between them. Compared with those without any high-risk harmonic pattern, patients with two of three high-risk harmonic characteristics had an approximately 80% increase in the incidence of microvascular events (HR, 1.76; 95% CI 1.44-2.16), and had more than doubled incidence of major adverse cardiovascular events (HR, 2.23; 95% CI 1.75-2.86) and macrovascular events (HR, 2.31; 95% CI 1.88...

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Section: Assessment Of Cardiovascular Risk In Type 2 Diabetes Patientmentioning

confidence: 99%

Assessment of cardiovascular risk in type 2 diabetes patients by insight into radial pulse wave harmonic index

Liao

Chang²,

Wang³

et al. 2019

Acta Physiologica

Self Cite

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“…https ://doi.org/10.14814/ phy2.14252 In Chang et al (2019), the following errors were published on page 3, 4, 5, 8, and 9…”

Section: E R R a T U Mmentioning

confidence: 99%

Erratum

2019

Physiol Rep

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“…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.…”

Section: Introductionmentioning

confidence: 99%

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

Haryadi

Chen

2021

JPM

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The harmonic analysis (HA) of arterial radial pulses in humans has been widely investigated in recent years for clinical applications of traditional Chinese medicine. This study aimed at establishing the validity of carrying out HA on synchronous peripheral volume pulses for predicting diabetes-induced subtle changes in heart energy. In this study, 141 subjects (Group 1: 63 healthy elderly subjects; Group 2: 78 diabetic subjects) were enrolled at the same hospital. After routine blood sampling, all synchronous electrocardiogram (ECG) and photoplethysmography (PPG) measurements (i.e., at the six locations) were acquired in the morning. HA of synchronous peripheral volume pulses and radial pulse waves was performed and analyzed after a short period of an ensemble averaging process based on the R-wave peak location. This study utilized HA for the peripheral volume pulses and found that the averaged total pulse energy (i.e., the C0 of the DTFS) was identical in the same subject. A logistic regression model with C0 and a waist circumference variable showed a graded association with the risk of developing type 2 diabetes. The adjusted odds ratio for C0 and the waist circumference were 0.986 (95% confidence interval: 0.977, 0.994) and 1.130 (95% confidence interval: 1.045, 1.222), respectively. C0 also showed significant negative correlations with risk factors for type 2 diabetes mellitus, including glycosylated hemoglobin and fasting plasma glucose (r = −0.438, p < 0.001; r = −0.358, p < 0.001, respectively). This study established a new application of harmonic analysis in synchronous peripheral volume pulses for clinical applications. The findings showed that the C0 could be used as a prognostic indicator of a protective factor for predicting type 2 diabetes.

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Risk assessment of macrovascular and microvascular events in patients with type 2 diabetes by analyzing the amplitude variation of the fourth harmonic component of radial pulse wave

Cited by 9 publications

References 33 publications

Assessment of cardiovascular risk in type 2 diabetes patients by insight into radial pulse wave harmonic index

Assessment of cardiovascular risk in type 2 diabetes patients by insight into radial pulse wave harmonic index

Erratum

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

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