Pulse wave analysis as an experimental tool to clinical application: Past and present (Review)

Abstract

Pulse examination by palpation of a peripheral artery against a bony prominence is the most commonly used and widely accepted method. However this is subjective and thus prone to errors. Although pulse waveform was recorded in the 19th century, it did not gain popularity because of inconvenience in using the recording instruments and the absence of a sound theory to explain the wave forms recorded. Sphygmomanometry for recording blood pressure gained popularity as it was easy to record and had a sound theoretical background. Sphygmomanometry provides two extreme values of blood pressure but does not give a true representation of the blood pressure changes occurring in the entire cardiac cycle. Recently there has been resurgence in the analysis of the graphical recording of the pulse wave. Photoplethysmography is becoming a widely accepted technique in assessing the volume pulse. The whole review is about historical background, non-invasive methods of pulse recording, relation of the digital volume pulse to the pressure pulse and the advantages of recording the pressure pulse.

Multi-Sensor Fusion Approach for Cuff-Less Blood Pressure Measurement

“…Possible reasons for this degradation include, the indistinctive pulse characteristic in PPG signals due to the influence of peripheral microvascular tissue resistance smoothing the PPG morphology [27]; as well as high-sensitivity in PTT calculated from ECG and finger PPG. The pulse pressure waveform (PPW), which is rich in significant characteristic information such as dicrotic wave for diverse population, has been well-studied for evaluation of arterial stiffness and cardiac function [28], [29]. However, few studies exist regarding the utility of the PPW for cuff-less BP estimation.…”

Estimation of individual-specific progression to impending cardiovascular instability using arterial waveforms

“…The shape and oscillatory pattern of arterial waveforms change when circulating blood volume is reduced. These changes occur in response to compensatory alterations in cardiac and vascular functions, which, in turn, alter features of the ejected and reflected pressure waves (4). With the emergence of advanced sensor technologies like photoplethysmography and volume-clamp pressure waveforms, the noninvasive recording of analog arterial waveform signals has become feasible, enabling real-time estimations of stroke volume during progressive reductions in central blood volume.…”

El análisis de la onda de pulso y el riesgo cardiovascular en individuos normotensos: un ejercicio con el Power Lab

“…El lugar donde se origine la reflexión sistólica sobre la onda sistólica determina el riesgo vascular, esto debido a que las reflexiones cercanas a la base son clasificadas como riesgo bajo y las cercanas a la cúspide como riesgo alto (3). En este estudio encontramos que los individuos con presencia de reflexión sistólica tendían a presentar anchos de onda sistólica mayores que no sobresalían más allá del 50% de la onda sistólica (es decir muy cerca a la base de la onda), por lo cual estos individuos pueden entrar dentro del grupo de riesgo cardiovascular bajo, incluso si sus valores de presión arterial se encuentran dentro de los rangos normales.…”

“…Al analizar el fenómeno del pulso se encuentran dos momentos importantes: la onda sistólica (OS) seguida de la onda diastólica (OD); estas ondas coinciden en duración de tiempo con la sístole y diástole cardiaca (Figura 1). Existe un fenómeno llamado "la reflexión sistólica" que es una segunda onda u onda intermedia que aparece en medio de la onda sistólica y la onda diastólica; al parecer, esta forma es causada por la reflexión de la onda antes de la formación de la Onda diastólica y depende de la elasticidad de las arterias (3). Clínicamente se ha propuesto como un indicador y predictor de salud y riesgo cardiovascular, ya que los individuos con presencia de reflexión sistólica podrían tener una mayor rigidez arterial (4).…”