Abstract
Background: The effects of position and exercise on pulse wave distribution across a healthy, compliant arterial tree are not fully understood. We studied the effects of exercise and position on the pattern of pulse arrival times (PATs) in healthy volunteers. Moreover, we compared the pulse arrival time ratios to the respective distance ratios between different locations.Methods: Thirteen young healthy volunteers were studied, using an electrocardiogram and plethysmograph to simultaneously record pulse wave arrival at the ear lobe, index finger and big toe. We compared the differences in PAT between each location at rest and post-exercise in the supine, sitting, and standing position. We also compared the PAT ratio (toe/ear, toe/finger, and finger/ear) to the corresponding pulse path distance ratios.Results: PAT was shortest at the ear then finger and longest at the toe regardless of position or exercise status. PATs were shorter post-exercise compared to rest. When transitioning from a standing to sitting or supine position, PAT to the ear decreased, while the PAT to the toe increased, and PAT to the finger didn't significantly change. PAT ratios were significantly smaller than predicted by the path distance ratios regardless of position or exercise status.Conclusions: Exercise makes PATs shorter. Standing position decrease PAT to the toe and increase to the ear. We conclude that PAT and PAT ratio represent the arterial vascular tree properties as surely as pulse transit time and pulse wave velocity.
Highlights
When the heart contracts it ejects a bolus of blood, the stroke volume, into the arterial vascular system, which is distributed to the peripheral tissues
Despite the fact that we used similar methodology as other groups, our study was focused on the effect of exercise and position on Pulse arrival time (PAT), and we believe that our work is substantially different and adds new knowledge to the prior work published by Nitzan et al (2002) and the group of Allen and Murray (2002)
(2) PATs are shorter post-exercise irrespective of the subject’s position, most likely due to an exercise-induced increase in sympathetic activity leading to a global increase in Peripheral Vascular BedsPulse wave velocity (PWV)
Summary
When the heart contracts it ejects a bolus of blood, the stroke volume, into the arterial vascular system, which is distributed to the peripheral tissues. Pulse arrival to the peripheral vascular beds, the PTT, is the time from aortic valve opening till the foot of the pulse waveform at the peripheral site. Since it is impossible to directly measure aortic valve opening from an ECG alone, Pulse arrival time (PAT) has been widely used instead of PTT. PAT is defined as the time delay between the peak of the R wave of the ECG waveform and the arrival (upstroke) of the arterial pulse wave in the periphery. We studied the effects of exercise and position on the pattern of pulse arrival times (PATs) in healthy volunteers. We compared the pulse arrival time ratios to the respective distance ratios between different locations
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