Pulse wave velocity in healthy subjects and in patients with various disease states

doi:10.1016/0002-8703(71)90229-8

American Heart Journal

Volume 82, Issue 4, October 1971, Pages 448-457

https://doi.org/10.1016/0002-8703(71)90229-8 Get rights and content

Abstract

Pulse wave velocity (PWV) was determined in 105 healthy subjects and in 199 patients suffering from eight different pathologic states. A noninvasive photoplethys-mographic technique was used and two time periods were measured: (1) between the “feet” of the pulse waves of the femoral and the dorsalis pedis arteries and (2) between the QRS complex and the pulse wave of the dorsalis pedis artery.

PWV was found to increase significantly with age. Hypertension was accompanied by increased PWV only in older subjects, while peripheral vascular disease was associated with decreased PWV. No significant change was observed in normotensive subjects suffering from ischemic heart disease, rheumatic heart disease, congestive heart failure, diabetes mellitus, or anemia.

The time interval between the feet of the femoralis and dorsalis pedis arteries, Δt(f−f), was not altered significantly by cardiac pacing at a fixed and at increasing heart rates in eight patients with A-V block. Beat-to-beat measurements in eight cases of chronic atrial fibrillation showed that Δt(f−f) was constant and independent of the preceding cycle length and, therefore, of variations in blood pressure. Premature beats generated Δt(f−f)'s which were equal to or shorter than those generated by sinus or postpremature beats.

On the other hand, the interval between the Q wave of the ECG and the foot of the pulse wave of the dorsalis pedis artery, Δt(Q−f, d.p.), was prolonged by cardiac pacing and was inversely related to the preceding cycle length in atrial fibrillation. Likewise, Δt(Q−f, d.p.)'s generated by premature beats were longer than those of sinus and postpremature beats. This finding is interpreted as indicating a prolongation of the “left ventricular tension period,” rather than a change in the propagation time of the pulse wave.

The difference in behavior of the two time intervals mentioned above should be taken into consideration in measurements of PWV.

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However, there is uncertainty as to the changes in PWV in advanced PAD. Some small studies suggest that in advanced PAD, a reduced rather than increased PWV may occur,11–13 a change that could be attributed to a decline in distending pressures distal to arterial stenoses.14 Decreases in distending pressures would result in an attenuation of arterial stiffness (a shift to a less steep portion of the exponential vascular pressure–volume relationship) and thus PWV in these distal segments, and hence cast doubt on the utility of aortic PWV as a predictor of advanced PAD.
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In CLI, while PPc increases, carotid–femoral PWV is markedly reduced. A PPc/PWV mismatch may be a new risk marker for advanced PAD.
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First, some of CAD patients had impaired leg circulation that was not evident from ABI. It is reported that PWV of the lower-limb arteries is decreased in the presence of significant stenosis in these arteries [23,24,32]. It is also known that, calcified arteries are often incompressible, resulting in higher ABI and masking the presence of PAD.
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The 2798 subjects were selected from 3300 consecutive participants of our non-invasive vascular lab. 342 subjects had one or more pre-existing atherosclerotic diseases including 128 CAD (N = 128), CVD (N = 195) and PAD (N = 83). PWVs were simultaneously measured using an automated pulse wave analyzer (model BP-203RPE, Colin) in the heart–femoral (hf, aorta), heart–carotid (hc), heart–brachial (hb), and femoral–ankle (fa) segments.
As compared to the subjects without atheroscletoric disease, those with CAD, CVD, or PAD showed higher levels of PWV in the four arterial segments, particularly in hfPWV. The relative increase in hfPWV remained significant after adjustment for age, sex, hypertension, pulse rate, smoking, diabetes mellistus, dyslipidemia, and chronic kidney disease.
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The PPG yields a low-noise signal, which enables accurate determination of its minimum, i.e., the arrival time of pressure pulse. Two PPG probes along two sites in an artery let to calculate the PTT consequently assess the pulse wave velocity along the arterial system.3 Therefore, PTT is a reliable noninvasive method for the experimental assessment of arterial stiffness.4,5
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The study consisted of two sessions of auricular acupuncture in the HG acupoint: first, in the right ear, and after seven days of washout period, in the left ear.
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The PTT was significantly increased by acupuncture in HG in both ears when comparing the pre- and post-acupuncture values. In the total sample, the Pearson correlation coefficients between basal values of PTT and the differences elicited through auriculopuncture showed a non-significantly positive correlation for the right ear, and significantly negative for the left ear.
Results indicate that each one of HG auricular acupoints has differentiated effects on the PTT of healthy subjects. Moreover, the effect of this acupoint depends on the basal state of PTT.
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Estudio experimental transversal.
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Clinical communicationPulse wave velocity in healthy subjects and in patients with various disease states

Abstract

Amer. Heart J.

Circulation

The effect of blood pressure on the extensibility of the human artery

Heart

The determination of the propagation velocity of the arterial pulse wave

Amer. J. Physiol.

The Lumbeian lectures on the arterial pulse in health and disease (I, II, III)

Lancet

The Lumbeian lectures on the arterial pulse in health and disease (I, II, III)

Lancet

The Lumbeian lectures on the arterial pulse in health and disease (I, II, III)

Lancet

Immediate variations in pulse wave velocity caused by adrenalin in short uniform parts of the arterial tree

Amer. J. Physiol.

Interpretation of arterial elasticity from measurements of pulse wave velocity

Amer. Heart J.

Studies on pulse wave velocity. III. Pulse wave velocity in pathological conditions

Amer. J. Physiol.

Pulse wave velocity under varying conditions in normal and abnormal human cardiovascular system

J. Clin. Invest.

Measurements of pulse wave velocity

Amer. J. Physiol.

Arterial elasticity in man in relation to age as evaluated by the pulse wave velocity method

Arch. Intern. Med.

Pulse wave velocity and arterial elasticity in arterial hypertension, arteriosclerosis, and related conditions

Amer. Heart J.

Studies on the arterial pulse wave, particularly in the aorta

Acta Physiol. Scand.

Effect of age on pulse wave velocity and “aortic ejection time” in healthy men and in men with coronary artery disease

Circulation

The peripheral pulse as a diagnostic tool

Angiology

Studies on pulse wave velocity in potential diabetic subjects

Diabetes

Carotid-femoral pulse wave velocity

J. Amer. Geriat. Soc.

Discussion sur l'élasticité artérielle

Bibl. Cardiol.

Studies of circulatory disturbances, pulse wave velocity and pressure pulses in larger arteries in cases of pseudoxanthoma elasticum and angioid streaks; contribution to knowledge of function of elastic tissue and smooth muscles in larger arteries

Acta Med. Scand.

Clinical communication
Pulse wave velocity in healthy subjects and in patients with various disease states