Relationship between radial and central arterial pulse wave and evaluation of central aortic pressure using the
Kenji Takazawa1, Hideyuki Kobayashi, Naohisa Shindo
1Department of Cardiology, Tokyo Medical University Hachioji Medical Center, Japan. takazawa@tokyo-med.ac.jp
Insights
Measuring radial artery pulse waves, specifically late systolic blood pressure, alongside brachial blood pressure may offer a more accurate assessment of central aortic systolic blood pressure changes. This aids cardiovascular disease prevention and treatment.
Area of Science:
- Cardiovascular Physiology
- Hemodynamics
- Medical Diagnostics
Background:
- Central aortic pressure is crucial for cardiovascular event prevention.
- Accurate measurement of central aortic pressure is valuable for managing cardiovascular diseases.
- Non-invasive methods for assessing central hemodynamics are highly sought after.
Purpose of the Study:
- To compare changes in central aortic systolic blood pressure (a-SBP) with radial artery blood pressure (r-SBP) and augmentation index (AI) before and after nicorandil administration.
- To evaluate the utility of non-invasive radial pulse wave analysis in estimating central aortic pressure dynamics.
- To determine if radial artery measurements can reliably reflect changes in a-SBP.
Main Methods:
- Simultaneous invasive measurement of ascending aortic pressure and non-invasive radial artery pulse waves.
- Administration of nicorandil to induce hemodynamic changes.
- Comparison of changes in a-SBP and various radial artery pressure parameters (early and late systolic).
- Calculation and comparison of aortic AI (a-AI) and radial AI (r-AI).
Main Results:
- Nicorandil caused a significantly larger reduction in a-SBP compared to early r-SBP.
- Late systolic blood pressure in the radial artery (r-SBP2) showed a reduction not significantly different from a-SBP.
- Strong correlations were found between changes in a-SBP and both Deltar-SBP (r=0.81) and Deltar-SBP2 (r=0.91).
- The correlation slope for Deltar-SBP2 (0.83) was closer to 1:1 than for Deltar-SBP (0.63).
- Significant correlations were observed between a-AI and r-AI both before (r=0.91) and after (r=0.70) nicorandil administration.
Conclusions:
- Non-invasive radial artery pulse wave analysis, particularly focusing on late systolic pressure changes, can provide a reliable estimation of central aortic systolic blood pressure modifications.
- These findings suggest that radial artery measurements, combined with brachial blood pressure, may enhance the evaluation of central hemodynamic changes.
- This approach could improve cardiovascular disease risk assessment and treatment monitoring.
Abstract:
Since a decrease of central aortic pressure contributes to the prevention of cardiovascular events, simple measurement of not only brachial blood pressure but also central aortic pressure may be useful in the prevention and treatment of cardiovascular diseases. In this study, we simultaneously measured radial artery pulse waves non-invasively and ascending aortic pressure invasively, before and after the administration of nicorandil. We then compared changes in central aortic pressure and radial arterial blood pressure calibrated with brachial blood pressure in addition to calculating the augmentation index (AI) at the aorta and radial artery. After nicorandil administration, the reduction in maximal systolic blood pressure in the aorta (Deltaa-SBP) was -14+/-15 mmHg, significantly larger than that in early systolic pressure in the radial artery (Deltar-SBP) (-9+/-12 mmHg). The reduction in late systolic blood pressure in the radial artery (Deltar-SBP2) was -15+/-14 mmHg, significantly larger than Deltar-SBP, but not significantly different from Deltaa-SBP. There were significant relationships between Deltaa-SBP and Deltar-SBP (r=0.81, p<0.001), and between Deltaa-SBP and Deltar-SBP2 (r=0.91, p<0.001). The slope of the correlation regression line with Deltar-SBP2 (0.83) was larger and closer to 1 than that with Deltar-SBP (0.63), showing that the relationship was close to 1:1. Significant correlations were obtained between aortic AI (a-AI) and radial AI (r-AI) (before nicorandil administration: r=0.91, p<0.001; after administration: r=0.70, p<0.001). These data suggest that the measurement of radial artery pulse wave and observation of changes in the late systolic blood pressure in the radial artery (r-SBP2) in addition to the ordinary measurement of brachial blood pressure may enable a more accurate evaluation of changes in maximal systolic blood pressure in the aorta (a-SBP).
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