Abstract
Pulse wave velocity (PWV) has been recommended as an arterial damage assessment tool and a surrogate of arterial stiffness. However, the current technology does not allow to measure PWV both continuously and in real-time. We reported previously that peripherally measured ejection time (ET) overestimates ET measured centrally. This difference in ET is associated with the inherent vascular properties of the vessel. In the current study we examined ETs derived from plethysmography simultaneously at different peripheral locations and examined the influence of the underlying arterial properties on ET prolongation by changing the subject’s position. We calculated the ET difference between two peripheral locations (ΔET) and its corresponding PWV for the same heartbeat. The ΔET increased with a corresponding decrease in PWV. The difference between ΔET in the supine and standing (which we call ET index) was higher in young subjects with low mean arterial pressure and low PWV. These results suggest that the difference in ET between two peripheral locations in the supine vs standing positions represents the underlying vascular properties. We propose ΔET in the supine position as a potential novel real-time continuous and non-invasive parameter of vascular properties, and the ET index as a potential non-invasive parameter of vascular reactivity.
Highlights
For the clinician it is important to distinguish patients with a compliant vasculature from those with stiff vessels [1]
Consistent with our hypothesis we found that higher values for ΔET in the supine position are generally observed in younger patients with lower mean arterial pressure (MAP) and lower Pulse wave velocity (PWV) indicating that the prolongation of the ejection time (ET) at more distal sites compared to more proximal sites might represent novel index of vascular properties
Given that the ΔET is longest in the supine position and shortest when standing we looked at the difference (ET index) in individual subjects as a potential marker to distinguish a compliant from a stiff vasculature
Summary
For the clinician it is important to distinguish patients with a compliant vasculature from those with stiff vessels [1]. Ejection Times Index as a novel marker of vascular stiffness attempts have been made to develop a BP independent index of vascular stiffness, such as the Cardio-Ankle Vascular Index (CAVI) and the Arterial Stiffness Index (ASI) [7,8]. They are not consistently BP independent in all clinical scenarios [8,9]. There is a clinical need to develop a real time continuous and noninvasive marker of vascular stiffness
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