Decoding carotid pressure waveforms recorded by laser Doppler vibrometry: Effects of rebreathing

Abstract

The principal goal of this study was to assess the capability of the laser Doppler vibrometry (LDV) method for assessing cardiovascular activity. A rebreathing task was used to provoke changes within individuals in cardiac and vascular performance. The rebreathing task is known to produce multiple effects, associated with changes in autonomic drive as well as alterations in blood gases. The rise in CO2 (hypercapnia), in particular, produces changes in the cerebral and systemic circulation. The results from a rebreathing task (involving rebreathing the same air in a rubber bag) are presented for 35 individuals. The LDV pulse was measured from a site overlying the carotid artery. For comparison and validation purposes, several conventional measures of cardiovascular function were also obtained, with an emphasis on the electrocardiogram (ECG), continuous blood pressure (BP) from the radial artery, and measures of myocardial performance using impedance cardiography (ICG). During periods of active rebreathing, ventilation increased. The conventional cardiovascular effects included increased mean arterial BP and systemic vascular resistance, and decreased cardiac stroke volume (SV) and pulse transit time (PTT). These effects were consistent with a pattern of α-adrenergic stimulation. During the immediate post-rebreathing segments, in contrast, mean BP was largely unaffected but pulse BP increased, as did PTT and SV, whereas systemic vascular resistance decreased-a pattern consistent with β-adrenergic effects in combination with the direct effects of hypercapnia on the vascular system. Measures of cardiovascular activity derived from the LDV pulse velocity and displacement waveforms revealed patterns of changes that mirrored the results obtained using conventional measures. In particular, the ratio of the maximum early peak in the LDV velocity pulse to the maximum amplitude of the LDV displacement pulse (in an early systolic interval) closely mirrored the conventional SV effects. Additionally, changes in an augmentation ratio (computed as the maximum amplitude of the LDV displacement pulse during systole / amplitude at the end of the incident wave) were very similar to changes in systemic vascular resistance. Heart rates measured from the ECG and LDV were nearly identical. These preliminary results suggest that measures derived using the non-contact LDV technique can provide surrogate measures for those obtained using impedance cardiography.