Variation in carotid-femoral pulse wave velocity, augmentation pressure and augmentation index during different phases of menstrual cycle

Abstract

Physiological variation of estrogen and progesterone during menstrual cycle is well known. They not only have an effect on blood pressure control, but also seem to have a role in regulating arterial compliance. This study was done to find out whether there are any changes in central arterial parameters during different phases of menstrual cycle. Thirty female subjects in the age group of 18-22 years with normal, regular menstrual cycles participated in this prospective observational study at our teaching hospital. Anthropometric parameters were recorded. Blood pressure in all 4 limbs was recorded using cardiovascular risk analyzer-Periscope™ on Day 3rd to 5th (follicular phase), Day 12th to 14th (ovulation phase), Day 22nd to 24th (luteal phase) of their menstrual cycle. We collected blood samples during these three phases for estimation of estradiol and progesterone by ELISA technique. Analysis of variance and correlation statistics were done using SPSS 17.0 statistical software. No significant statistical changes were observed in systolic blood pressure, diastolic blood pressure, mean arterial pressure, pulse pressure, aortic systolic pressure, aortic diastolic pressure, aortic augmentation pressure, aortic index and pulse wave velocity during the three recorded phases of the menstrual cycle. There are many studies which correlate changes in peripheral artery blood pressure with different phases of menstrual cycle. But there is scarcity in data available which correlates central arterial pressures and arterial stiffness with natural hormonal variations in different phases of menstrual cycle. However, our results show that although there are subtle changes in blood pressure parameters along with estrogen and progesterone levels throughout the menstrual cycle, yet these were not statistically significant.

Establishment of a Modular Hemodynamic Simulator for Accurate In Vitro Simulation of Physiological and Pathological Pressure Waveforms in Native and Bioartificial Blood Vessels

“…Here, mid-descending aortas served as an example for the application of central pressure waveforms, brachial and radial arteries were used to demonstrate pressure curves in medium-diameter vessels and inferior venae cavae were stimulated under typical central venous pressures. For the aorta, a pulse pressure of 38 mmHg ± 0.82 mmHg resulted in a relative wall strain of 5.5% ± 0.36% and a typical pressure waveform for the mid-descending aorta with a broad maximum and an early incisura 18 (Fig. 4 (1)).…”

“…Measured pressure curves (continuous line) and target pressure waveforms adapted from Refs. 3 , 13 , 18 , 27 (dotted line) were normalized to the pulse pressure range (aorta, brachial an radial arteries) or mean pressure (inferior vena cava) to allow qualitative comparison of the obtained MHS-waveform to the ideal waveform by producing an overlay for each vessel type. Absolute pressure values are listed in (A).…”

“…Both the different physiological and pathological pressure curves obtained in the MHS were compared to ideal pressure curves described for healthy individuals or patients with the respective cardiovascular pathologies. Physiological reference pressure curves were obtained from Kahkashan et al, 18 Oliver et al, 27 Huang et al 13 and Chambers et al 3 Likewise, characteristic pathological pressure waveforms typically associated with cardiovascular pathologies were obtained from Sabbah et al, 36 Jenkins et al, 16 Denardo et al, 5 Skorton et al 38 and Nichols et al 26 For comparison, the ideal pressure curves were digitalized using the ''Engauge Digitizer'' software as well. Since pressure curves reproduced in basic literature are usually only given as qualitative waveforms without standardized scales for pressure and time, both the measured and the ideal pressure curves had to be normalized to a common scale to facilitate qualitative comparison.…”