Abstract
An early return of the reflected component in the arterial pulse has been recognized as an important indicator of cardiovascular risk. This study aimed to determine the effects of blood pressure and sex factor on the change of wave reflection using Gaussian fitting method. One hundred and ninety subjects were enrolled. They were classified into four blood pressure categories based on the systolic blood pressures (i.e., ≤110, 111–120, 121–130 and ≥131 mmHg). Each blood pressure category was also stratified for sex factor. Electrocardiogram (ECG) and radial artery pressure waveforms (RAPW) signals were recorded for each subject. Ten consecutive pulse episodes from the RAPW signal were extracted and normalized. Each normalized pulse episode was fitted by three Gaussian functions. Both the peak position and peak height of the first and second Gaussian functions, as well as the peak position interval and peak height ratio, were used as the evaluation indices of wave reflection. Two-way ANOVA results showed that with the increased blood pressure, the peak position of the second Gaussian significantly shorten (P<0.01), the peak height of the first Gaussian significantly decreased (P<0.01) and the peak height of the second Gaussian significantly increased (P<0.01), inducing the significantly decreased peak position interval and significantly increased peak height ratio (both P<0.01). Sex factor had no significant effect on all evaluation indices (all P>0.05). Moreover, the interaction between sex and blood pressure factors also had no significant effect on all evaluation indices (all P>0.05). These results showed that blood pressure has significant effect on the change of wave reflection when using the recently developed Gaussian fitting method, whereas sex has no significant effect. The results also suggested that the Gaussian fitting method could be used as a new approach for assessing the arterial wave reflection.
Highlights
The shapes of artery pressure waveform are determined by the cardiac ejection function and the mechanical and geometric properties of the systemic arteries
The previous studies have showed that the wave reflection changed with the age and hypertension factors when using the traditional clinical indices, such as pulse wave velocity (PWV), augmentation index (AI), reflection index (RI) and stiffness index (SI) [15,27,28,29]
All the blood pressure variables (SBP, diastolic blood pressure (DBP), mean arterial pressure (MAP) and pulse pressure (PP)) have significant differences in the systolic blood pressure (SBP) category whereas they have no significant differences in the sex category
Summary
The shapes of artery pressure waveform are determined by the cardiac ejection function and the mechanical and geometric properties of the systemic arteries. The backward component (i.e., wave reflection from the periphery to the heart, named reflected component) has been recognized as an important indicator of cardiovascular risk [4,5,6,7]. If the reflected component comes back earlier to the heart (usually in the late systole), it will conduce the rise of the central systolic and pulse pressures and will depress the coronary perfusion pressure [5]. For these reasons, it is important to accurately estimate the amount and location of the wave reflection [8,9,10,11,12]
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