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Pulse-wave analysis: clinical evaluation of a noninvasive, widely applicable method for assessing endothelial
Ian B Wilkinson1, Ian R Hall, Helen MacCallum
1Clinical Pharmacology Units, University of Cambridge, Addenbrooke's Hospital, Cambridge, England. ibw20@cam.ac.uk
Arteriosclerosis, Thrombosis, and Vascular Biology
|January 15, 2002
Summary
Pulse-wave analysis (PWA) offers a noninvasive method to assess endothelial function. This technique, combined with pharmacological tests, effectively measures vasomotor endothelial function in large studies.
Area of Science:
- Cardiovascular Physiology
- Vascular Biology
- Diagnostic Methodology
Background:
- Assessing endothelial function is crucial for cardiovascular health.
- Current methods for evaluating endothelial function are often impractical for large-scale studies.
- Pulse-wave analysis (PWA) presents a potential noninvasive alternative.
Purpose of the Study:
- To investigate if pulse-wave analysis (PWA) combined with pharmacological testing can serve as a practical method for assessing endothelial function.
- To evaluate the reliability and repeatability of PWA in measuring changes in vascular tone.
- To compare PWA-based endothelial function assessment with traditional methods.
Main Methods:
- Radial artery waveforms were recorded, and the augmentation index (AIx) was calculated from derived aortic waveforms.
- Pharmacological agents including nitroglycerin (NTG), albuterol, and N(G)-monomethyl-L-arginine (LNMMA) were administered.
- Endothelial function was assessed using PWA and forearm blood flow measurements in hypercholesterolemic subjects and controls.
Main Results:
- Both albuterol and NTG significantly reduced AIx, indicating a repeatable effect.
- The endothelial nitric oxide synthase inhibitor LNMMA selectively inhibited the albuterol-induced AIx reduction, confirming an endothelium-dependent mechanism.
- Hypercholesterolemic subjects showed higher baseline AIx and a blunted response to albuterol compared to controls.
- PWA-derived responses to albuterol correlated with intra-arterial acetylcholine responses.
Conclusions:
- Pulse-wave analysis combined with provocative pharmacological testing is a simple, repeatable, and noninvasive method for assessing endothelial function in vivo.
- This PWA-based approach is suitable for large studies and can detect endothelial dysfunction in conditions like hypercholesterolemia.
- The findings support the use of PWA as a valuable tool in cardiovascular research and clinical practice.