Radial-digital pulse wave velocity: a noninvasive method for assessing stiffness of small conduit arteries

Obeid, Hasan; Fortier, Catherine; Côté, Nadège; Paré, Mathilde; Boutouyrie, P.; Bruno, Rosa Maria; Khettab, Hakim; Goupil, Rémi; Agharazii, Mohsen

doi:10.1152/ajpheart.00551.2020

Cited by 14 publications

(11 citation statements)

References 28 publications

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“…There are also limitations that should be mentioned. First, we did not examine the smaller arteries of the vascular bed through the assessment of radial-digital PWV ( Obeid et al, 2021 ). Second, it would have also been interesting to assess the local distensibility of both carotid and femoral arteries.…”

Section: Discussionmentioning

confidence: 99%

Modulation of Arterial Stiffness Gradient by Acute Administration of Nitroglycerin

et al. 2021

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Background: Physiologically, the aorta is less stiff than peripheral conductive arteries, creating an arterial stiffness gradient, protecting microcirculation from high pulsatile pressure. However, the pharmacological manipulation of arterial stiffness gradient has not been thoroughly investigated. We hypothesized that acute administration of nitroglycerin (NTG) may alter the arterial stiffness gradient through a more significant effect on the regional stiffness of medium-sized muscular arteries, as measured by pulse wave velocity (PWV). The aim of this study was to examine the differential impact of NTG on regional stiffness, and arterial stiffness gradient as measured by the aortic-brachial PWV ratio (AB-PWV ratio) and aortic-femoral PWV ratio (AF-PWV ratio).Methods: In 93 subjects (age: 61 years, men: 67%, chronic kidney disease [CKD]: 41%), aortic, brachial, and femoral stiffnesses were determined by cf-PWV, carotid-radial (cr-PWV), and femoral-dorsalis pedis artery (fp-PWV) PWVs, respectively. The measurements were repeated 5 min after the sublingual administration of NTG (0.4 mg). The AB-PWV and AF-PWV ratios were obtained by dividing cf-PWV by cr-PWV or fp-PWV, respectively. The central pulse wave profile was determined by radial artery tonometry through the generalized transfer function.Results: At baseline, cf-PWV, cr-PWV, and fp-PWV were 12.12 ± 3.36, 9.51 ± 1.81, and 9.71 ± 1.89 m/s, respectively. After the administration of NTG, there was a significant reduction in cr-PWV of 0.86 ± 1.27 m/s (p < 0.001) and fp-PWV of 1.12 ± 1.74 m/s (p < 0.001), without any significant changes in cf-PWV (p = 0.928), leading to a significant increase in the AB-PWV ratio (1.30 ± 0.39 vs. 1.42 ± 0.46; p = 0.001) and AF-PWV ratio (1.38 ± 0.47 vs. 1.56 ± 0.53; p = 0.001). There was a significant correlation between changes in the AF-PWV ratio and changes in the timing of wave reflection (r = 0.289; p = 0.042) and the amplitude of the heart rate-adjusted augmented pressure (r = − 0.467; p < 0.001).Conclusion: This study shows that acute administration of NTG reduces PWV of muscular arteries (brachial and femoral) without modifying aortic PWV. This results in an unfavorable profile of AB-PWV and AF-PWV ratios, which could lead to higher pulse pressure transmission into the microcirculation.

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Section: Discussionmentioning

confidence: 99%

Modulation of Arterial Stiffness Gradient by Acute Administration of Nitroglycerin

et al. 2021

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“…Recently, based on the pulse waveform recorded at the radial and digital arteries, the radial-digital PWV has become available as a measure of the regional stiffness of small conduit arteries [ 66 ]. The clinical implication of this measurement has not yet been clarified.…”

Section: Concepts and Clinical Evidencementioning

confidence: 99%

Expert Consensus on the Clinical Use of Pulse Wave Velocity in Asia

Park¹,

Sharman²,

Li³

et al. 2022

Pulse

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Arterial stiffness is a progressive aging process that predicts cardiovascular disease. Pulse wave velocity (PWV) has emerged as a noninvasive, valid, and reliable measure of arterial stiffness and an independent risk predictor for adverse outcomes. However, up to now PWV measurement has mostly been used as a tool for risk prediction and has not been widely used in clincial practice. This consensus paper aims to discuss multiple PWV measurements currently available in Asia and to provide evidence-based assessment together with recommendations on the clinical use of PWV. For the methodology, PWV measurement including the central elastic artery is essential and measurements including both the central elastic and peripheral muscular arteries, such as brachial-ankle PWV and Cardio-Ankle Vascular Index, can be a good alternative. As Asian populations are rapidly aging, timely detection and intervention of "early vascular aging" in terms of abnormally high PWV values is recommended. More evidence is needed to determine if a PWV-guided therapeutic approach will be beneficial to the prevention of cardiovascular diseases beyond current strategies. Large-scale randomized controlled intervention studies are needed to guide clinicians.

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“…Unlike applanation tonometry, piezoelectric sensors capture PW signals without the need for arteries to be flattened, thus being suitable for wearable, long-term monitoring of PWs [ 74 ]. Several approaches based on piezoelectric sensors have been described featuring different materials, geometry, and numbers of required sensing elements to be placed on subjects’ bodies [ 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , 86 , 87 , 88 , 89 ]. Wang et al described a rigid piezoelectric sensor applied on the wrist to measure PW signals and estimate blood pressure via PW analysis [ 76 ].…”

Section: Introductionmentioning

confidence: 99%

“…Several approaches based on piezoelectric sensors have been described featuring different materials, geometry, and numbers of required sensing elements to be placed on subjects’ bodies [ 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , 86 , 87 , 88 , 89 ]. Wang et al described a rigid piezoelectric sensor applied on the wrist to measure PW signals and estimate blood pressure via PW analysis [ 76 ]. Obeid et al used a commercial PWV measurement system, also based on rigid piezoelectric sensors, to estimate blood pressure from radial–digital PWV measurements, obtained by computing the pulse transit time (PTT) between PW signals acquired on the radial artery in the wrist and digital arteries in the fingers [ 76 ].…”

Section: Introductionmentioning

confidence: 99%

“…Wang et al described a rigid piezoelectric sensor applied on the wrist to measure PW signals and estimate blood pressure via PW analysis [ 76 ]. Obeid et al used a commercial PWV measurement system, also based on rigid piezoelectric sensors, to estimate blood pressure from radial–digital PWV measurements, obtained by computing the pulse transit time (PTT) between PW signals acquired on the radial artery in the wrist and digital arteries in the fingers [ 76 ]. Taranchuk and Pidchenko proposed a particular piezoelectric PW sensor based on a quartz resonator [ 77 ].…”

Section: Introductionmentioning

confidence: 99%

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Multimodal Finger Pulse Wave Sensing: Comparison of Forcecardiography and Photoplethysmography Sensors

Andreozzi

Sabbadini

Centracchio

et al. 2022

Sensors

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Pulse waves (PWs) are mechanical waves that propagate from the ventricles through the whole vascular system as brisk enlargements of the blood vessels’ lumens, caused by sudden increases in local blood pressure. Photoplethysmography (PPG) is one of the most widespread techniques employed for PW sensing due to its ability to measure blood oxygen saturation. Other sensors and techniques have been proposed to record PWs, and include applanation tonometers, piezoelectric sensors, force sensors of different kinds, and accelerometers. The performances of these sensors have been analyzed individually, and their results have been found not to be in good agreement (e.g., in terms of PW morphology and the physiological parameters extracted). Such a comparison has led to a deeper comprehension of their strengths and weaknesses, and ultimately, to the consideration that a multimodal approach accomplished via sensor fusion would lead to a more robust, reliable, and potentially more informative methodology for PW monitoring. However, apart from various multichannel and multi-site systems proposed in the literature, no true multimodal sensors for PW recording have been proposed yet that acquire PW signals simultaneously from the same measurement site. In this study, a true multimodal PW sensor is presented, which was obtained by integrating a piezoelectric forcecardiography (FCG) sensor and a PPG sensor, thus enabling simultaneous mechanical–optical measurements of PWs from the same site on the body. The novel sensor performance was assessed by measuring the finger PWs of five healthy subjects at rest. The preliminary results of this study showed, for the first time, that a delay exists between the PWs recorded simultaneously by the PPG and FCG sensors. Despite such a delay, the pulse waveforms acquired by the PPG and FCG sensors, along with their first and second derivatives, had very high normalized cross-correlation indices in excess of 0.98. Six well-established morphological parameters of the PWs were compared via linear regression, correlation, and Bland–Altman analyses, which showed that some of these parameters were not in good agreement for all subjects. The preliminary results of this proof-of-concept study must be confirmed in a much larger cohort of subjects. Further investigation is also necessary to shed light on the physical origin of the observed delay between optical and mechanical PW signals. This research paves the way for the development of true multimodal, wearable, integrated sensors and for potential sensor fusion approaches to improve the performance of PW monitoring at various body sites.

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Radial-digital pulse wave velocity: a noninvasive method for assessing stiffness of small conduit arteries

Cited by 14 publications

References 28 publications

Modulation of Arterial Stiffness Gradient by Acute Administration of Nitroglycerin

Modulation of Arterial Stiffness Gradient by Acute Administration of Nitroglycerin

Expert Consensus on the Clinical Use of Pulse Wave Velocity in Asia

Multimodal Finger Pulse Wave Sensing: Comparison of Forcecardiography and Photoplethysmography Sensors

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