Measurement of Stiffness Index by Digital Volume Pulse Analysis Technique: Clinical Utility in Cardiovascular Disease Risk Stratification

Gunarathne, Ashan; Patel, Jeetesh V.; Hughes, Elizabeth; Lip, Gregory Y.H.

doi:10.1038/ajh.2008.207

Cited by 59 publications

(46 citation statements)

References 29 publications

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“…Within subject variability of the SI using the Pulse Trace device was 3.5% in this study and comparable to the findings reported by Gunarathne et al 20 (5.4%). As measurement of the SI with the Pulse Trace device is operator-independent, inter-observer variability of the SI was neither assessed in the current nor in the study by Gunarathne et al 20 Comparable within subject variability of the AIx assessed by the Sphygmocor device has been reported by Wilkinson et al 21 (5.3%) and Siebenhofer et al 22 (6.4%).…”

Section: Discussionsupporting

confidence: 91%

“…As measurement of the SI with the Pulse Trace device is operator-independent, inter-observer variability of the SI was neither assessed in the current nor in the study by Gunarathne et al 20 Comparable within subject variability of the AIx assessed by the Sphygmocor device has been reported by Wilkinson et al 21 (5.3%) and Siebenhofer et al 22 (6.4%). Using the operator index of the Sphygmocor device to assure consistency of waveforms the inter-observer variability was found to be 7.5% in a recent study by Wassertheurer et al 23 We found a modest correlation between the digital SI and the peripheral and central AIx derived by arterial applanation tonometry.…”

Section: Discussioncontrasting

confidence: 53%

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Comparison of photoplethysmographic and arterial tonometry-derived indices of arterial stiffness

et al. 2011

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Arterial tonometry is a method to assess arterial stiffness and has become a valuable tool in the stratification of cardiovascular risk. The arterial tonometry-derived augmentation index (AIx) is a marker of arterial stiffness and an independent predictor of mortality. As the AIx is relatively cumbersome to obtain, simpler methods such as analysis of pulse waves obtained by digital photoplethysmography have been proposed to estimate arterial stiffness. The objective of this study is to compare the usefulness of the stiffness index (SI) derived from digital photoplethysmography and the AIx derived from radial tonometry for stratification of cardiovascular risk. We studied 83 subjects with a heterogeneous cardiovascular risk profile and determined the ability of the two devices to differentiate subjects with low from subjects with high cardiovascular risk estimated by the Europe (EU)-heart score. Failure rate in both devices was similar (3.6%). AIx and SI were modestly correlated (r¼0.48, Po0.001) and both indexes correlated with the EU-score (r¼0.54, Po0.001) and (r¼0.56, Po0.001), respectively. Both devices discriminated accurately between subjects with high cardiovascular risk (upper tertile of the EU-score) and low cardiovascular risk (lower tertile). However, only the SI differentiated significantly between subjects with intermediate risk (middle tertile) and high risk (upper tertile). Compared with the AIx, assessment of the SI derived by digital photoplethysmography is simple and possibly yields an advantage in risk stratification of subjects with intermediate and high cardiovascular risk. Therefore, digital pulse wave analysis may be a valuable tool to estimate arterial stiffness in large clinical studies.

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Section: Discussionsupporting

confidence: 91%

Section: Discussioncontrasting

confidence: 53%

Comparison of photoplethysmographic and arterial tonometry-derived indices of arterial stiffness

et al. 2011

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“…All of the measurements were performed by the same operator. Intraobserver variation (coefficient of variation) of the repeated measurements of arterial stiffness in the same subject on the same day and 6 weeks later was 5.4% and 7.4%, respectively, 25 …”

Section: Arterial Stiffness and Endothelial Measurement Protocolmentioning

confidence: 93%

“…The DVP analysis method is a noninvasive technique of measuring pulse wave reflections to determine the arterial stiffness peripherally. 24 Arterial stiffness using this has been proven to be a validated, reproducible technique 25 with minimal intraobserver variation. 29 The stiffness index derived from this method has been demonstrated to have a good correlation to pulse wave velocity, 26 whereas the sensitivity and specificity of this technique are comparable to the pulse wave velocity method in the identification of patients with latent cardiovascular disease.…”

Section: Measurements Of Arterial Stiffnessmentioning

confidence: 99%

Glycemic Status Underlies Increased Arterial Stiffness and Impaired Endothelial Function in Migrant South Asian Stroke Survivors Compared to European Caucasians

Gunarathne

Patel

Kausar

et al. 2009

Stroke

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Background-The pathophysiology of an increased risk of cerebrovascular disease mortality among South Asians (SA) remains unclear. Indices of arterial stiffness and endothelial dysfunction are independent markers of vascular disease, having both prognostic and diagnostic implications. We hypothesized that there are ethnic variations in indices of arterial stiffness and endothelial dysfunction between SA and European Caucasian (EC) stroke patients, which may underline a poorer prognosis in the former, and further investigated promoters of vessel wall abnormalities. Methods-Using a cross-sectional approach, a total of 100 SA stroke survivors were prospectively recruited from the ongoing West Birmingham Stroke Project. Indices of vessel wall characteristics (arterial stiffness and endothelial function [change in reflective index]) were measured noninvasively using the digital volume pulse analysis technique in a temperature-controlled environment, using a direct standardized approach. SA stroke subjects were compared to 60 EC stroke survivors, 60 SA with risk factors, and 73 healthy controls. Results-Among stroke patients, both ethnic groups were comparable for cardiovascular risk profile, except for more diabetes mellitus in SA (Pϭ0.007) subjects and a higher prevalence of atrial fibrillation in EC (Pϭ0.04) subjects. According to the TOAST and Bamford classifications, SA subjects had more small vessel (Pϭ0.04) and lacunar infarctions (Pϭ0.01). SA subjects had higher measurements of arterial stiffness (PϽ0.001) and impaired endothelialdependent vascular function (change in reflective index %; PϽ0.001). On univariate analysis, endothelial function was negatively correlated with fasting plasma glucose (rϭϪ0.4; PϽ0.001) and total cholesterol level (rϭϪ0.2; PϽ0.001).On multivariate analysis, glycemic status was independently associated with impaired endothelial function (Pϭ0.008) and increased arterial stiffness (PϽ0.001) among SA subjects. Conclusion-SA stroke survivors had more small vessel disease-related cerebrovascular events compared to EC subjects.Underlying glycemic status in SA subjects had an adverse impact on the vascular system, leading to abnormal vessel wall characteristics. (Stroke. 2009;40:2298-2306.)

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“…Arterial stiffness measured using digital volume pulse (DVP) analysis has been proved to be validated and reproducible technique with minimal intraobserver variation [7] and is a more sensitive tool in risk stratification for CVD in comparison to plasma glucose, total cholesterol, and waist to hip ratio in apparently healthy population [8].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Neutrophil-Lymphocyte Ratio and Arterial Stiffness Indices Among Young Prehypertensives: A Cross-Sectional Study

Deepika

2018

Asian J Pharm Clin Res

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Objective: The aim of the present study is to evaluate the arterial stiffness indices and neutrophil-lymphocyte ratio (NLR) in young prehypertensives.Methods: This was a cross-sectional study carried as a part of the medical health check-up program conducted on 150 students joining 1 st year MBBS. Based on their blood pressure (BP) recordings they were classified as normotensives and prehypertensives. Arterial stiffness indices were assessed using finger photoplethysmography, and NLR was evaluated using automated hematological analyzer. Student's t-test and Pearson's correlation were performed using SPSS version 16 and p<0.05 was considered as statistically significant. Results:Of the 150 subjects, 106 were recruited for the present study. Based on BP, they were grouped as normotensives (n=66) and prehypertensives (n=40). Arterial stiffness indices, namely, stiffness index (SI) and reflection index (RI) reported a significant increase among the prehypertensive group with p=0.003 and p=0.002, respectively. SI and RI showed a positive correlation with systolic BP, diastolic BP, heart rate, and body mass index (BMI). NLR reported a significant increase in a prehypertensive group with p=0.03 but no correlation was found between NLR and arterial stiffness indices. Conclusion:Targeting the high-risk individuals, based on increased arterial stiffness, NLR, BMI and BP, for earlier lifestyle modifications could act as a potential preventive strategy to inhibit the development of cardiovascular diseases.

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Measurement of Stiffness Index by Digital Volume Pulse Analysis Technique: Clinical Utility in Cardiovascular Disease Risk Stratification

Abstract: Noninvasive measurements of arterial stiffness may aid the optimal stratification of CVD risk in an apparently healthy population.

Cited by 59 publications

References 29 publications

Comparison of photoplethysmographic and arterial tonometry-derived indices of arterial stiffness

Comparison of photoplethysmographic and arterial tonometry-derived indices of arterial stiffness

Glycemic Status Underlies Increased Arterial Stiffness and Impaired Endothelial Function in Migrant South Asian Stroke Survivors Compared to European Caucasians

Evaluation of Neutrophil-Lymphocyte Ratio and Arterial Stiffness Indices Among Young Prehypertensives: A Cross-Sectional Study

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