Pulse wave velocity in healthy subjects and in patients with various disease states

Abstract

Pulse wave velocity (PWV) was determined in 105 healthy subjects and in 199 patients suffering from eight different pathologic states. A noninvasive photoplethys-mographic technique was used and two time periods were measured: (1) between the “feet” of the pulse waves of the femoral and the dorsalis pedis arteries and (2) between the QRS complex and the pulse wave of the dorsalis pedis artery. PWV was found to increase significantly with age. Hypertension was accompanied by increased PWV only in older subjects, while peripheral vascular disease was associated with decreased PWV. No significant change was observed in normotensive subjects suffering from ischemic heart disease, rheumatic heart disease, congestive heart failure, diabetes mellitus, or anemia. The time interval between the feet of the femoralis and dorsalis pedis arteries, Δ t( f− f), was not altered significantly by cardiac pacing at a fixed and at increasing heart rates in eight patients with A-V block. Beat-to-beat measurements in eight cases of chronic atrial fibrillation showed that Δ t( f− f) was constant and independent of the preceding cycle length and, therefore, of variations in blood pressure. Premature beats generated Δ t( f− f)'s which were equal to or shorter than those generated by sinus or postpremature beats. On the other hand, the interval between the Q wave of the ECG and the foot of the pulse wave of the dorsalis pedis artery, Δ t( Q− f, d. p.), was prolonged by cardiac pacing and was inversely related to the preceding cycle length in atrial fibrillation. Likewise, Δ t( Q− f, d. p.)'s generated by premature beats were longer than those of sinus and postpremature beats. This finding is interpreted as indicating a prolongation of the “left ventricular tension period,” rather than a change in the propagation time of the pulse wave. The difference in behavior of the two time intervals mentioned above should be taken into consideration in measurements of PWV.