Application of Arterial Pulse Waveform for Diagnosis and Treatment of Chronic Diseases

Abstract

BackgroundPulse wave is the vibration generated by the heart pulsating ejection along the elastic duct of the artery. It is affected by many factors such as the heart itself, the elasticity of the blood vessel wall and the viscosity of the blood. The main wave of the pulse wave is composed of a rising branch and a descending branch, and the descending branch contains a dicrotic wave. The left ventricle contracts and ejects blood, the aorta dilates, the blood pressure rises, and the ascending branch is formed. Ejection velocity slows down, blood pressure drops, forming the descending branch; The left ventricle dilates, the aortic valve closes, blood flows back and rebounds after impacting aortic valve, forming a repulse. The changes of pulse wave shape can indicate many physiological and pathological phenomena.MethodsEleven patients with chronic disease (mainly with abnormalities of sugar, lipid and pressure) and 8 healthy subjects were selected. The pulse wave was measured at rest and then individualized precise exercise was developed according to the results of each person's cardiopulmonary exercise testing (CPET). The program allowed the subjects to perform a single individualized precise exercise, measured the pulse wave again, recorded the pulse wave at 5, 15, 30, and 40 minutes after exercise. Then re‐mapped, calculated the feature points. The differences of pulse wave between patients with chronic disease and healthy people at rest and after exercise were compared, and the changes of pulse wave between patients and healthy people before and after exercise was summarized respectively.ResultsUnder resting state, healthy people had obvious dicrotic waves, while patients with chronic diseases had no obvious or no dicrotic waves. After exercise, the main wave peak of healthy people became higher, the waveform became narrower, and the dicrotic waves deepened; Similarly, the main wave peak of the patients became higher, the waveform became narrower, and most importantly, the dicrotic waves occurred which not had appeared at rest, or unconspicuous dicrotic waves turned obvious.ConclusionUnder the guidance of new theory of holistic integrative physiology and medicine, the sugar, lipid or pressure abnormalities are caused by abnormal supply and demand of oxygen, energy substances and metabolites in life regulation. We treat abnormal sugar, fat and pressure as one kind of disease for the first time. A single individualized precise exercise can significantly change the pulse wave of patients with chronic diseases, suggesting that pulse waves have a certain significance in the effective diagnosis and treatment of chronic diseases. We will expand the sample size to further explore the effectiveness of individualized precision exercise in strengthening control of chronic diseases in the aspect of pulse wave.Support or Funding InformationNational Natural Science Foundation of China (81470204);Fuwai Hospital, National Cardiovascular Institute of Chinese Academy of Medical Sciences (2012‐YJR02);Research on Clinical Characteristics of the Capital (Z141107002514084);Research and Outcome Promotion of Clinical Characteristics in the Capital (Project No. Z161100000516127)