Related Experiment Video
Updated: Jun 8, 2026
Measuring the Carotid to Femoral Pulse Wave Velocity (Cf-PWV) to Evaluate Arterial Stiffness
Published on: May 3, 2018
Novel application of parameters in waveform contour analysis for assessing arterial stiffness in aged and
Hsien-Tsai Wu1, Cyuan-Cin Liu, Po-Hsun Lin
1Department of Electrical Engineering, National Dong Hwa University, Hualien, Taiwan.
Insights
New indices, normalized crest time (NCT) and crest time ratio (CTR), reliably assess arterial stiffness in atherosclerosis patients. These novel parameters overcome limitations of conventional methods when pulse wave analysis is challenging.
Area of Science:
- Cardiovascular Research
- Biomedical Engineering
- Medical Diagnostics
Background:
- Arterial stiffness is a key indicator of cardiovascular health and a predictor of atherosclerosis.
- Conventional pulse wave analysis (PWA) parameters like stiffness index (SI) and reflection index (RI) can be inaccurate in aged or atherosclerotic individuals due to distorted waveforms.
- Accurate non-invasive assessment of arterial stiffness is crucial for managing cardiovascular risk.
Purpose of the Study:
- To evaluate the reliability of novel indices, normalized crest time (NCT) and crest time ratio (CTR), for assessing arterial stiffness.
- To compare the performance of NCT and CTR against conventional PWA parameters in a population with potential waveform distortions.
- To determine if NCT and CTR offer advantages in populations where conventional parameters are difficult to ascertain.
Main Methods:
- Digital volume pulse (DVP) curves were analyzed from 428 health screening participants.
- Conventional parameters including pulse wave velocity (PWV), crest time (CT), SI, and RI were recorded.
- NCT and CTR were calculated and compared with conventional parameters and demographic/clinical data.
Main Results:
- NCT and CTR remained unaffected by waveform ambiguity, unlike SI and RI, due to a constant sum of CT and DVP duration.
- Both NCT and CTR demonstrated significant correlations with age, blood pressure, PWV, SI, and RI (P<0.01).
- These novel indices proved valuable even when the dicrotic notch was indiscernible.
Conclusions:
- NCT and CTR are reliable and valuable indices for assessing arterial stiffness, particularly in subjects with distorted pulse waveforms.
- These novel parameters offer a robust alternative for evaluating arterial stiffness when conventional methods fail due to waveform characteristics.
- NCT and CTR show significant correlations with established markers of atherosclerosis and arterial stiffness, supporting their clinical utility.
Objective:
Although contour analysis of pulse waves has been proposed as a non-invasive means in assessing arterial stiffness in atherosclerosis, accurate determination of the conventional parameters is usually precluded by distorted waveforms in the aged and atherosclerotic objects. We aimed at testing reliable indices in these patient populations.
Methods:
Digital volume pulse (DVP) curve was obtained from 428 subjects recruited from a health screening program at a single medical center from January 2007 to July 2008. Demographic data, blood pressure, and conventional parameters for contour analysis including pulse wave velocity (PWV), crest time (CT), stiffness index (SI), and reflection index (RI) were recorded. Two indices including normalized crest time (NCT) and crest time ratio (CTR) were also analysed and compared with the known parameters.
Results:
Though ambiguity of dicrotic notch precluded an accurate determination of the two key conventional parameters for assessing arterial stiffness (i.e. SI and RI), NCT and CTR were unaffected because the sum of CT and T(DVP) (i.e. the duration between the systolic and diastolic peak) tended to remain constant. NCT and CTR also correlated significantly with age, systolic and diastolic blood pressure, PWV, SI and RI (all P<0.01).
Conclusion:
NCT and CTR not only showed significant positive correlations with the conventional parameters for assessment of atherosclerosis (i.e. SI, RI, and PWV), but they also are of particular value in assessing degree of arterial stiffness in subjects with indiscernible peak of diastolic wave that precludes the use of conventional parameters in waveform contour analysis.
Related Concept Videos
01:23Assessment of blood pressure in brachial artery(two-step method)
01:15Assessment of blood pressure in brachial artery(one-step method)
Prepare for the Procedure:
01:19Assessing Blood pressure using a doppler ultrasound
Pre-Procedural Guidelines for Doppler Ultrasound Blood Pressure Assessment:
Preparation of Equipment:
01:21Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation
01:27Atherosclerosis II: Clinical Manifestations and Diagnostic Tests
01:25Assessment of apical radial pulse
The A-R pulse assessment involves simultaneous evaluation of the apical and radial pulses. When the apical and radial pulse rates vary, this assessment helps identify a pulse deficit.
Pre-Procedural Preparation