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[Value of the measurement of pulse wave velocity during exertion]
J P Siché1, R de Gaudemaris, J M Mallion
1Service de Médecine Interne et Cardiologie, CHRU, Grenoble.
Abstract:
Establishing an arterial compliance index by measuring pulse wave velocity (PWV) has proved useful for the early diagnosis of arterial lesions in atherosclerosis and diabetes, but the lack of reproducibility of this measurement when performed at rest has limited its use. Exercise tests, a global method for the dynamic study of blood pressure (BP) level, has been suggested as a means of standardizing the neurosensorial influences on the vasomotor tone. In this paper, we advocate a dynamic evaluation of arterial compliance by measurement of PWV during exercise, and we report the results of our study concerning the reproducibility of PWV during exercise, and we report the results of our study concerning the reproducibility of PWV measurements and the changes observed in arterial compliance during dynamic constraints. Thirty normotensive subjects aged from 20 to 30 years were studied on two occasions separated by more than 24 hours. PWV was measured in the subclavian and radial arteries by doppler shifted ultrasound combined with ECG, both at rest and after 3 levels (50, 75, 100 watts) of a standard triangular exercise test in sitting position. BP levels during exercise were the same in both tests. The reproducibility of PWV measurements in these two tests confirmed the non-reproducibility of these measurements at rest. It also showed that reproducibility is obtained during the first minutes of exercise (r = 0.72 ; p less than 0.001 at 75 watts). Changes in PWV at exercise varied with the subject, with a mean progressive increase of 1 m/s/level (rest = 9.8, 50 w = 11.1, 75 w = 12.2, 100 w = 13.14; 4 min. later: 10.7 m/s).(ABSTRACT TRUNCATED AT 250 WORDS)