[Individualized analysis of pulse wave shape before and after a single accurate power exercise in patients with...

Objective: To observe and study the resting radial artery pulse wave and changes after a single individualized exercise in patients with long-term chronic diseases. Methods: We selected 16 patients with chronic disease (disease duration ≥5 years) who have been clearly diagnosed as hypertension and/or diabetes and/or hyperlipemia, and first completed the symptom-restricted limit cardiopulmonary exercise testing (CPET). Then a single individualized exercise with Δ50% power as the exercise intensity was completed within one week after CPET. We measured and recorded 50s pulse wave data before exercise and 10 min, 20 min, 30 min after exercise, then obtained each pulse wave characteristic point: starting point (B), main wave peak point (P1), trough of a repulse point (PL), crest of a repulse point (P2), and end point (E). The raw data of the abscissa (time T) and ordinate (amplitude Y) corresponding to each point were derived from the instrument. We treated the end point E of the previous pulse wave as the start point B of the next wave, returned TB to zero, and got the main observation indicators: YB, YP1, YPL, YP2 and TP1, TPL, TP2, TE, and calculated out ΔYP1, ΔYPL, ΔYP2, TE-TPL, (TE-TPL)/TPL, pulse rate, S1, S2 ,ΔYP2-ΔYPL and TP2-TPL as secondary observation indicators. Then calculated the occurrence rate of dicrotic wave with obvious crest. Finally we analyzed individually the 50 s pulse wave data of each patient before and after exercise, and then averaged all the data for overall analysis. Results: ①16 patients with long-term chronic diseases (males 14, females 2), ages (53.7±12.6, 28~80) years old, height (171.7±6.6, 155~183) cm, body weight (80.0±13.5, 54~98) kg. 2YB (91.5±10.8, 71.1~108.6), YP1 (203.6±24.7, 162.7~236.3), YPL (127.1±6.2, 118.2~140.3), YP2 (125.9±6.2, 115.7~137.7), TP1 ( 137.2±22.3, 103.0~197.1), TPL (368.7±29.5, 316.3~434.0), TP2 (422.7±32.8, 376.9~494.7), TE (883.4±95.0, 672.2~1003.3), ΔYP1 (112.1±33.8, 60.3~ 157.5), ΔYPL (35.5±14.2, 17.5~66.2), ΔYP2 (34.4±13.3, 20.0~62.9), TE-TPL (514.6±85.4, 341.4~621.9), (TE-TPL)/TPL (1.4±0.2, 1.0~1.7), pulse rate (68.8±8.4, 59.8~89.3), S1 (0.9±0.3, 0.4~1.4), S2 (0.0±0.0, -0.1~0.0), ΔYP2-ΔYPL (-1.2±2.6,- 6.5 ~ 2.5), TP2-TPL (54.0 ± 10.8, 33.6 ~ 81.1). ③10min after exercise, YB, YPL, YP2, TPL, TE decreased, YP1 increased. ΔYPL, TE-TPL, (TE-TPL)/TPL decreased, and ΔYP1, pulse rate, S1, ΔYP2-ΔYPL, TP2 -TPL increased (all P<0.05). The change trend of pulse wave at 20min and 30min after exercise was consistent with that at 10min after exercise, but most indicators gradually recovered to the resting level before exercise from 10 min. ④The appearance rate of dicrotic wave with obvious crest in 16 patients with long-term chronic disease at rest was 28.6%, and the appearance rate of 10 min (65.7%), 20 min (77.1%), 30 min (73.7%) after exercise was significantly increased (all P< 0.01). In 6 patients, the incidence of dicrotic waves with obvious peaks after exercise was significantly increased, and it could continue until 30 minutes. In 3 patients, the incidence increased significantly 10 minutes after exercise, and began to decrease at 20 minutes. In 1 patient, the rate of appearance only started to increase 20 minutes after exercise. In 2 patients, the incidence increased 10 minutes after exercise and then decreased. In 1 patient, the rate of occurrence increased briefly 20 minutes after exercise and then decreased. The incidence of 1 patient dropped after exercise and began to rise at 20 minutes. In 2 cases, the incidence rate did not increase after exercise, and it increased slightly after 30 minutes. Conclusion: In patients with long-term chronic diseases, the radial artery pulse wave is short and the dicrotic wave is not obvious or even disappears. After a single precise power exercise, the main wave increases, the position of the dicrotic wave decreases, and the amplitude increases. The specific response should be analyzed individually.