Differences in the Properties of the Radial Artery betweenCun,Guan,Chi, and Nearby Segments Using Ultrasonographic Imaging: A Pilot Study on Arterial Depth, Diameter, and Blood Flow

Introduction:This study aims to investigate the effects of acupuncture stimulation on the radial artery’s pressure pulse wave, along with various hemodynamic parameters, and to explore the possible underlying mechanism of pulse diagnosis in healthy participants in their twenties.Methods and analysis:This study is a prospective, single-arm, exploratory clinical study. A total of 25 healthy participants, without regard to gender, in their twenties will be recruited by physicians. Written informed consent will be obtained from all participants. The participants will receive acupuncture once at ST36 on both sides. The radial arterial pulse waves will be measured on the left arm of the subjects by using an applicable pulse tonometric device (KIOM-PAS). On the right arm (appearing twice), electrocardiogram (ECG), photoplethysmogram (PPG), respiration and cardiac output (CO) signals, will be measured using a physiological data acquisition system (Biopac module), while the velocity of blood flow, and the diameter and the depth of the blood vessel will be measured using an ultrasonogram machine on the right arm (appearing twice). All measurements will be conducted before, during, and after acupuncture. The primary outcome will be the spectral energy at high frequencies above 10 Hz (SE10-30Hz) calculated from the KIOM-PAS device signal. Secondary outcomes will be various variables obtained from the KIOM-PAS device, ECG, PPG, impedance cardiography modules, and an ultrasonogram machine.Discussion:The results of this trial will provide information regarding the physiological and the hemodynamic mechanisms underlying acupuncture stimulation and clinical evidence for the influence of acupuncture on the pressure pulse wave in the radial artery.Ethics and dissemination:This study was approved by the Institutional Review Board (IRB) of Kyung Hee University’s Oriental Medical Center, Seoul, Korea (KOMCIRB-150818-HR-030). The study findings will be published in peer-reviewed journals and presented at national and international conferences.Trial registration number: This trial was registered with the Clinical Research Information Service (CRIS) at the Korea National Institute of Health (NIH), Republic of Korea (KCT0001663), which is a registry in the World Health Organization’s (WHO’s) Registry Network.

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“…1 . In this study, the technician will measure the pulse signals at the Gwan (Guan) location [ 25 ].…”

Section: Methods and Analysismentioning

confidence: 99%

Effects of Acupuncture Stimulation on the Radial artery’s Pressure Pulse Wave in Healthy Young Participants: Protocol for a prospective, single-Arm, Exploratory, Clinical Study

Shin

Lee

et al. 2016

J. Pharmacopunct

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“…A drawing of the vessel with associated dimensions is shown in Figure 3A. The radial artery has been reported to have 2.5mm inner diameter and 0.2 wall thickness [38][39][40] . Vessel wall mass density and Poisson's ratio were set to 1160 kg/m 3 and 0.49 36,38,41 respectively.…”

Section: Vessel Geometrymentioning

confidence: 99%

“…Below the dermis, a subcutaneous adipose tissue layer was added. Within this layer, the radial artery is modeled as a cylinder situated at 2.5mm depth from the top surface 39,40 . The target radial artery is constructed with a vessel wall and the internal lumen is filled with blood.…”

Section: Monte Carlo Modelmentioning

confidence: 99%

“…Along with changes to the skin, the artery itself is situated deeper in the subcutaneous adipose tissue as adipose tissue layer thickness with increasing level of obesity. The signal from the radial artery is discovered to vary in depth with different levels of obesity from 2.5mm for nonobese individuals at BMI of 25 to 3.5mm for BMI of 45 39,40 . Trans-epidermal water loss (TEWL) the process where water evaporates through the epidermis from the dermis is disruption in the obese 30 .…”

Section: Monte Carlo Modelmentioning

confidence: 99%

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Synthetic Photoplethysmography (PPG) of the radial artery through parallelized Monte Carlo and its correlation to Body Mass Index (BMI)

Boonya-Ananta

Rodriguez

Ajmal

et al. 2020

Preprint

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Cardiovascular disease is one of the leading causes of death in the United States and obesity significantly increases the risk of cardiovascular disease. The measurement of blood pressure (BP) is critical in monitoring and managing cardiovascular disease hence new wearable devices are being developed to make the BP metric mode accessible to physicians and patients. Several wearables utilize photoplethysmography from the wrist vasculature to derive BP assessment although many of these devices are still at the experimental stage. With the ultimate goal of supporting instrument development, we have developed a model the photoplethysmographic waveform derived from the radial artery at the volar surface of the wrist. To do so we have utilized the relation between vessel biomechanics through Finite Element Method and Monte Carlo light transport model. The model shows similar features to that seen in PPG waveform captured using an off the shelf device. We observe the influence of body mass index (BMI) on the PPG signal. A degradation the PPG signal of up to 40% in AC to DC signal ratio was thus observed.

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“…These techniques evaluate the blood pressure of an individual at one instant in time and can be intrusive 10 . Cuff-based blood pressure measurement are known to have variations and inaccuracies when applied to larger arm sizes as in in individuals with obesity, as the subcutaneous adipose tissue layer increases in thickness [11][12][13] . The development of medical devices that account for physiological changes due to obesity is becoming more prevalent.…”

Section: Introductionmentioning

confidence: 99%

Modeling of a photoplethysmographic (PPG) waveform through monte carlo as a method of deriving blood pressure in individuals with obesity.

Boonya-Ananta

Rodriguez

Hansen³

et al. 2020

Optical Interactions With Tissue and Cells XXXI

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Systolic and diastolic blood pressure values can be used as an indicator of an individual's risk for cardiovascular disease. The common practice of blood pressure (BP) measurement using a cuff-based system provides a snapshot of blood pressure at a single instance in time and can be inconvenient and intrusive. The development of optical methods to determine blood pressure could provide continuous monitoring of blood pressure through techniques such as pulse transit time (PTT) or pulse arrival time (PAT) when used with echocardiogram. Cuff based BP devices are known to have variation and inaccuracies when applied to larger arm sizes as seen in individuals with obesity but little is known of the influence of obesity in the PPG/PTT and PAT signals. We propose that accurate waveform replication is required for the derivation of blood pressure applied to individuals with obesity. Here we use the Monte Carlo framework to develop the PPG waveform as a means to derive blood pressure through cuff less techniques. The development of a simulated waveform incorporates realistic changes in the artery related to its biomechanical properties as a pressure wave is propagated through the vessel. It is shown that a change in vessel pressure and geometry directly affects the captured optical signal. The system can account for variations in body-mass index to compensate for geometrical changes in adipose tissue layer and changes in optical properties.

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Differences in the Properties of the Radial Artery betweenCun,Guan,Chi, and Nearby Segments Using Ultrasonographic Imaging: A Pilot Study on Arterial Depth, Diameter, and Blood Flow

Cited by 28 publications

References 7 publications

Effects of Acupuncture Stimulation on the Radial artery’s Pressure Pulse Wave in Healthy Young Participants: Protocol for a prospective, single-Arm, Exploratory, Clinical Study

Effects of Acupuncture Stimulation on the Radial artery’s Pressure Pulse Wave in Healthy Young Participants: Protocol for a prospective, single-Arm, Exploratory, Clinical Study

Synthetic Photoplethysmography (PPG) of the radial artery through parallelized Monte Carlo and its correlation to Body Mass Index (BMI)

Modeling of a photoplethysmographic (PPG) waveform through monte carlo as a method of deriving blood pressure in individuals with obesity.

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