Reference Values in White Europeans for the Arterial Pulse Wave Recorded by Means of the SphygmoCor Device

Wojciechowska, Wiktoria; Staessen, Jan A.; Nawrot, Tim S.; Cwynar, Marcin; Seidlerová, Jitka; Stolarz, Katarzyna; Gąsowski, Jerzy; Tichá, M.; Richart, Tom; Thijs, Lutgarde; Grodzicki, Tomasz; Kawecka‐Jaszcz, Kalina; Filipovský, Jan

doi:10.1291/hypres.29.475

Cited by 67 publications

(48 citation statements)

References 21 publications

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“…[3][4][5] Reference values for the central hemodynamic variables as obtained by the SphygmoCor are available for Asians, 18 Blacks of native African origin, 19 and Europeans. 20 The SphygmoCor approach has been widely applied in randomized clinical trials with intermediate and hard outcomes. 21 These arguments support the use of tonometry by the SphygmoCor approach as a reference method in the present study.…”

Section: Discussionmentioning

confidence: 99%

24-h ambulatory recording of aortic pulse wave velocity and central systolic augmentation: a feasibility study

et al. 2012

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We assessed the feasibility of ambulatory pulse wave analysis by comparing this approach with an established tonometric technique. We investigated 35 volunteers (45.6 years; 51.0% women) exclusively at rest (R study) and 83 volunteers (49.9 years; 61.4% women) at rest and during daytime (1000-2000 h) ambulatory monitoring (R þ A study). We recorded central systolic (cSP), diastolic (cDP) and pulse (cPP) pressures, augmentation index (cAI) and pulse wave velocity (PWV) by brachial oscillometry (Mobil-O-Graph 24h PWA Monitor) and radial tonometry (SphygmoCor). We applied the Bland and Altman's statistics. In the R study, tonometric and oscillometric estimates of cSP (105.6 vs. 106.9 mm Hg), cDP (74.6 vs. 74.7 mm Hg), cPP (31.0 vs. 32.1 mm Hg), cAI (21.1 vs. 20.6%) and PWV (7.3 vs. 7.0 m s À1 ) were similar (PX0.11). In the R þ A study, tonometric vs. oscillometric assessment yielded similar values for cSP (115.4 vs. 113.9 mm Hg; P ¼ 0.19) and cAI (26.5 vs. 25.3%; P ¼ 0.54), but lower cDP (77.8 vs. 81.9 mm Hg; Po0.0001), so that cPP was higher (37.6 vs. 32.1 mm Hg; Po0.0001). PWV (7.9 vs. 7.4 m s À1 ) was higher (P ¼ 0.0002) on tonometric assessment. The differences between tonometric and oscillometric estimates increased (Pp0.004) with cSP (r ¼ 0.37), cAI (r ¼ 0.39) and PWV (r ¼ 0.39), but not (PX0.17) with cDP (r ¼ 0.15) or cPP (r ¼ 0.13). Irrespective of measurement conditions, brachial oscillometry compared with an established tonometric method provided similar estimates for cSP and systolic augmentation, but slightly underestimated PWV. Pending further validation, ambulatory assessment of central hemodynamic variables is feasible.

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Section: Discussionmentioning

confidence: 99%

24-h ambulatory recording of aortic pulse wave velocity and central systolic augmentation: a feasibility study

et al. 2012

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“…In the elderly, the inflection corresponding to return of the reflection wave, (identified by differentials as a concavity to left on the original wave) comes so close to the initial wave peak at around 100 ms that it merges, and no separate shoulder or inflection may be seen at all [31]. A consequence of the change in the aorta wave shape is that augmentation of the wave-the rise from the first shoulder or peak to second peak-increases progressively with age at least up to 60 years [22,58]. Rise at older ages is less steep; this may be due to change in shape of the aortic flow wave and attributable to decreased left ventricular output at high pressure in late systole, to reduction in wave reflection from the lower body as aortic wave velocity increases to match values of wave velocity in the iliac and femoral arteries [26], or to the difficulty in identifying the shoulder from which augmentation is measured [30,38].…”

Section: Change In Waveforms With Agementioning

confidence: 99%

“…One of these challenges is that augmentation index (AIx) of the pressure wave in the aorta, radial and carotid arteries does not increase progressively with age, flattening off over age 60 [10,22,58], and does not over 60 years correlate with cardiovascular events [51] whereas, aortic PWV (an accepted measure of stiffness) does increase progressively with age [15,22,30] and does correlate with events at all ages [15]. Related to this is that in diabetic subjects under age 60, with known greater risk of cardiovascular events, and with greater aortic PWV often have lower AIx than normal subjects [13].…”

Section: Apparent Anomaliesmentioning

confidence: 99%

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Time domain analysis of the arterial pulse in clinical medicine

O’Rourke

2008

Med Biol Eng Comput

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The arterial pulse at any site is created by an impulse generated by the left ventricle as it ejects blood into the aorta, together with multiple impulses travelling in the opposite direction from reflecting sites in the peripheral circulation. The compound wave at any site depends on the pattern of ventricular ejection, the properties of large arteries, particularly their stiffness (which determines rate of propagation) and the distance to and impedance mismatch at reflecting sites. Physicians are familiar with waveform analysis in the time domain, as in the electrocardiogram (ECG) where the principal features are explicable on the basis of atrial depolarisation followed by ventricular depolarisation, then repolarisation. Effects of cardiac functional and structural disease can be inferred from the ECG. It is more difficult to make similar interpretations from the pulse waveform and clinicians usually use this only to count heart rate, extremes of the pressure pulse to express systolic and diastolic pressure, and (sometimes) time from wave foot to incisural notch to measure time of systole and diastole. More information can be gleaned from the shape of the arterial pressure wave through consideration of the factors which create it-on stiffening of large arteries with age, effects of drugs on smallest arteries, and changes in such arterial properties on left ventricular load and function. Such is a major challenge to future physicians. It is aided by better and more accurate methods for measuring flow and diameter as well as pressure waveforms, and by appropriate use of other analytic techniques such as analysis of the pulse in the frequency domain.

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“…Alterations in arterial structure and function also occur with aging in healthy subjects. The increase in central arterial stiffness with age has been thought to be associated with age-related increases in the morbidity of cardiovascular disease (5)(6)(7). In addition, in subjects with metabolic-atherogenic disorders, including hypertension, diabetes mellitus, and hypercholesterolemia, the stiffness of the central arteries is known to be more pronounced (8)(9)(10).…”

Section: Introductionmentioning

confidence: 99%

Effect of Acute and Long-Term Aerobic Exercise on Arterial Stiffness in the Elderly

et al. 2007

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Arterial stiffness is an important factor for cardiovascular performance and a predictor of cardiovascular risk. We evaluated the effects of both acute and long-term aerobic exercise on arterial stiffness in community-dwelling healthy elderly subjects. In addition, we evaluated the relationship between the effects of longterm exercise and those of acute exercise. The study subjects were participants in the Shimanami Health Promoting Program study (J-SHIPP), which was designed to investigate factors relating to cardiovascular disease, dementia, and death (67 ± 6 years). They performed mild-to-moderate aerobic exercise lasting for 30 min twice a week for 6 months. Arterial stiffness was assessed before and after the first 30-min acute exercise (n =99) and long-term 6-month aerobic training (n =40). The radial arterial augmentation index (AI) obtained from the radial pulse waveform by the tonometry method was used as a parameter of arterial stiff-

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Reference Values in White Europeans for the Arterial Pulse Wave Recorded by Means of the SphygmoCor Device

Cited by 67 publications

References 21 publications

24-h ambulatory recording of aortic pulse wave velocity and central systolic augmentation: a feasibility study

24-h ambulatory recording of aortic pulse wave velocity and central systolic augmentation: a feasibility study

Time domain analysis of the arterial pulse in clinical medicine

Effect of Acute and Long-Term Aerobic Exercise on Arterial Stiffness in the Elderly

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