Previous noninvasive measurements of the pulse waveform of the radial artery have not employed standard positioning procedures. Here, we propose a new noninvasive measuring apparatus that has a two-axis mechanism and employs a standard positioning procedure for detecting the optimal site for accurately measuring the pressure pulse waveform (PPW). A modified sensor was designed to simultaneously measure the arterial diameter changed waveform (ADCW) and PPW. Considering the artery as a cylinder, the measured waveform would be distorted if the sensor were not at the middle of arterial width. Moreover, a blood vessel is elastic, and its compliance changes with the transmural pressure, being maximal when the transmural pressure is equal to zero. The sensor should detect the PPW with the lowest possible distortion and, hence, an analysis of the vascular geometry and an arterial model were used to design a standard positioning procedure based on the ADCW for the X and Z axes. In order to verify the resolution of the X axis scanning procedure, the echo method was used to measure the radial artery outer diameter in ten healthy subjects. The difference between the scanning width and the actual arterial diameter was 0.36 +/- 0.23 mm (mean +/- SD). Finally, the PPW as measured at the optimal position was used to diagnose myocardial ischemia symptoms in 60 elderly subjects whose chief complaint was chest pain, with the exercise electrocardiogram being used as a reference to compare between individuals with and without myocardial ischemia. The PPW analysis used the harmonic components in the frequency domain. We found that the fourth harmonic of the Fourier series differed significantly between the groups (p = 0.0039), which is consistent with previous studies. The results indicate that our noninvasive measurement apparatus is very suitable for analyzing the PPW of the radial artery.

BackgroundArterial pressure waveforms contain important diagnostic and physiological information since their contour depends on a healthy cardiovascular system [1]. A sensor was placed at the measured artery and some contact pressure was used to measure the pressure waveform. However, where is the location of the sensor just about enough to detect a complete pressure waveform for the diagnosis? How much contact pressure is needed over the pulse point? These two problems still remain unresolved.MethodIn this study, we propose a quantitative analysis to evaluate the pressure waveform for locating the position and applying the appropriate force between the sensor and the radial artery. The two-axis mechanism and the modified sensor have been designed to estimate the radial arterial width and detect the contact pressure. The template matching method was used to analyze the pressure waveform. In the X-axis scan, we found that the arterial diameter changed waveform (ADCW) and the pressure waveform would change from small to large and then back to small again when the sensor was moved across the radial artery. In the Z-axis scan, we also found that the ADCW and the pressure waveform would change from small to large and then back to small again when the applied contact pressure continuously increased.ResultsIn the X-axis scan, the template correlation coefficients of the left and right boundaries of the radial arterial width were 0.987 ± 0.016 and 0.978 ± 0.028, respectively. In the Z-axis scan, when the excessive contact pressure was more than 100 mm Hg, the template correlation was below 0.983. In applying force, when using the maximum amplitude as the criteria level, the lower contact pressure (r = 0.988 ± 0.004) was better than the higher contact pressure (r = 0.976 ± 0.012).ConclusionsAlthough, the optimal detective position has to be close to the middle of the radial arterial, the pressure waveform also has a good completeness with a template correlation coefficient of above 0.99 when the position was within ± 1 mm of the middle of the radial arterial range. In applying force, using the maximum amplitude as the criteria level, the lower contact pressure was better than the higher contact pressure.