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[Diagnostic value of the systolic part of the arterial pulse curve, registered using a bloodless technic]
Insights
Non-invasive carotid pulse wave analysis accurately reflects left ventricular contractility. Peripheral pulse wave crest time indicates arterial stiffness and can suggest peripheral artery disease.
Area of Science:
- Cardiovascular Physiology
- Biomedical Engineering
- Diagnostic Imaging
Context:
- Assessing left ventricular contractility typically requires invasive heart catheterization.
- Non-invasive methods for evaluating cardiac function and arterial health are highly sought after.
- Pulse wave analysis offers a potential non-invasive alternative for cardiovascular assessment.
Purpose:
- To compare invasive measures of left ventricular contractility with non-invasively measured carotid pulse waves.
- To correlate peripheral pulse wave characteristics (crest time) with cardiac function and arterial disease in a large patient cohort.
- To determine the diagnostic value of pulse wave parameters for conditions like hypertension and arteriosclerosis.
Summary:
- Left ventricular contractility indices (dp/dtmax, dp/dtmax/IP, t-dp/dt) showed significant correlation with the time to the first peak in the carotid pulse wave.
- Peripheral pulse wave crest time correlated with ejection time across all groups, being shortest in hypertensive patients and longest in arteriosclerosis patients.
- A long peripheral pulse wave crest time (pulsus tardus) is indicative of generalized arteriosclerosis, and a specific ratio can suggest leg artery stenosis.
Impact:
- Non-invasive carotid pulse wave analysis can provide valuable insights into left ventricular pressure development.
- Peripheral pulse wave analysis, particularly crest time, serves as a valuable, non-invasive indicator of arterial stiffness and disease.
- These findings support the use of pulse wave analysis as a diagnostic tool for cardiovascular and peripheral arterial diseases.
Abstract:
Left ventricular contractility of 20 patients, measured by heart catheterization was compared with simultaneously but unbloody registrated pulse wave of A. carotis. Furthermore the crest time of femoralis and dorsalis pedis pulse wave was correlated to ejection time, pulse wave velocity, blood pressure and the length of the arteries between heart and foot of 1112 patients suffering from hypertension, arteriosclerosis, circulatory dysregulation and of 182 healthy sportsmen. The indices of left ventricular contractility: dp/dtmax, dp/dtmax/IP and t-dp/dt correlated highly significant with the time between the onset of the systolic upstroke and the first peak in the carotis pulse wave. No correlation was found with ejection time and the last systolic peak of the carotis pulse. Crest time is always shorter in the pulse wave of the foot arteries than in the femoral artery. The crest time in the femoral- and foot pulse correlates in all groups significantly with ejection time, patients with hypertension have the shortest, patients with arteriosclerosis the longest crest times, the last independent from the ejection time. The time between the start of the systolic upstroke and the first systolic peak in the unbloody registrated carotis pulse wave gives indication to the pressure development in the left ventricle. A long crest time in the peripheral pulse (pulsus tardus) is a typical symptom of generalized arteriosclerosis. The combination of slow pulse wave velocity in the leg and long crest time in the foot arteries (quotient greater than 20.5) indicates a stenosis in the arteries of the leg.