Arterial Pulse Waveform Research Articles

Piezoelectric Micromachined Ultrasonic Transducer for Arterial Wall Dynamics Monitoring.

In this article, a [Formula: see text] piezoelectric micromachined ultrasonic transducer (PMUT) array is designed and driven with one cycle of a 5-MHz sinusoid at 10 [Formula: see text] for radial artery motion tracking. The transmit and receive performance figure of merit (FOM) of an individual PMUT over operating frequency is modeled and validated using laser Doppler vibrometer (LDV) measurements. Given a fixed cross section, the FOM inversely scales with frequency. The array aperture size is selected to obtain enough pressure and received signal to measure the radial artery wall reflection at a 5-mm depth in tissue. The 2-mm acoustic beamwidth provides enough lateral resolution for radial artery wall motion tracking. Single-line ultrasonic pulse-echo measurements with high time resolution, also called M-mode ultrasound imaging, are demonstrated to reproduce a known target motion profile with a precision of around 0.5 [Formula: see text]. In vivo radial artery dynamics are measured by placing the sensor on the wrist of a volunteer. The measured diameter change waveform of the radial artery is consistent with reports in the literature and captures key arterial pulse waveform features, including systolic upstroke, systolic decline, dicrotic notch, and diastolic runoff. The system has sufficient accuracy and precision to measure both the 50 [Formula: see text] overall diameter change and the 5- [Formula: see text] diameter change due to the dicrotic notch. A heart rate of 70 beats/min is also derived. This demonstrates the great potential of custom PMUT arrays for continuous cardiovascular system monitoring.

High-performance strain sensor for detection of human motion and subtle strain by facile fabrication

Flexible strain sensors are significant components for smart wearable electronic devices because of wide applications. However, the design and construction of high-performance strain sensors through facile fabrication remains a challenge. In this study, we designed a simple and high-performance flexible strain sensor based on gold nanoparticles and a polyimide substrate. The fabrication included drop-casting and high-temperature annealing, enhancing the connections between the nanoparticles. The results reveal that the sensor can sensitively detect subtle strains (GF = 19.94). It exhibits excellent linearity (R2 = 0.99) when sensing outward bending strain and low power consumption (<2.5 mW). Furthermore, it can be adhered to human skin to detect human physiological parameters. The strain sensor can detect the angles of the cervical vertebra in different bending states. It can show the distinctions of artery pulse waveforms at different conditions (before and after exercise) and in people (pregnant and unpregnant) with a high precision.

Separation of Forward-Backward Waves in the Arterial System using Multi-Gaussian Approach from Single Pulse Waveform.

The arterial pulse waveform has an immense wealth of information in its morphology yet to be explored and translated to clinical practice. Wave separation analysis involves decomposing a pulse wave (pressure or diameter waveform) into a forward wave and a backward wave. The backward wave accumulates reflections due to arterial stiffness gradient, branching and geometric tapering of blood vessels across the arterial tree. The state-of-the-art wave separation analysis is based on estimating the input impedance of the target artery in the frequency/time domain, which requires simultaneously measured or modelled flow velocity and pressure waveform. We are proposing a new method of wave separation analysis using a multi-gaussian decomposition. The novelty of this approach is that it requires only a single pulse waveform at the target artery. Our method was compared against the triangular waveform-based impedance method. We successfully separated forward and backward waveform from the pressure waveform with maximum RMSE less than 5 mmHg and mean RMSE of 1.31 mmHg when compared against the triangular flow/impedance method. Results demonstrated a statistically significant correlation (r>0.66, p<0.0001) for Reflection Magnitude (RM) and Reflection Index (RI) for the multi-gaussian approach against the triangular flow method for 105 virtual subjects. The range of RM was from 0.35 to 0.97 (RI: 27.53% to 49.29%). This method proves to be a technique for evaluating reflection parameters if only a single pulse measurement is available from any artery.Clinical Relevance- This simulation study supplements the evidence for wave reflections. It provides a new method to study wave reflections using only a single pulse waveform without the need for any measured or modelled flow.

Evaluation of Vascular Pulse Contour Indices over the Physiological Blood Pressure Ranges in an Anesthetized Porcine Model.

A series of physiological measures can be assessed from the arterial pulse waveform, which is beneficial for cardiovascular health diagnosis, monitoring, and decision making. In this work, we have investigated the variations in regional pulse wave velocity (PWVR) and other pulse waveform indexes such as reflected wave transit time (RWTT), augmentation index (Alx), ejection duration index (ED), and subendocardial viability ratio (SEVR) with blood pressure (BP) parameters and heartrate on a vasoconstrictor drug-induced porcine model. Two healthy female (nulliparous and non-pregnant) Sus scrofa swine (~ 80 kg) was used for the experimental study. The measurement system consists of a catheter-based system with two highly accurate pressure catheters placed via the sheath at the femoral and carotid artery for acquiring and recording the pressure waveforms. The pulse waveform indexes were extracted from these recorded waveforms. Results from the pulse contour analysis of these waveforms demonstrated that Phenylephrine, as a post-synaptic alpha-adrenergic receptor agonist that causes vasoconstriction, produced a significant increment in the carotid BP parameters and heartrate. Due to the drug's effect, the PWVR and SEVR were significantly increased, whereas the RWTT, AIx index and ED index significantly decreased.Clinical Relevance- This experimental study provides the usefulness of the pulse contour analysis and estimation of various pulse waveform indexes for cardiovascular health screening and diagnosis.

Development on Linearizing Front End and Amplification Structure for Commercial GMR Sensor-based Cardiorespiratory Monitoring system.

Magnetoplethysmogram (MPG) is typically acquired by placing a giant magnetoresistance sensor (GMR)-magnet system in a blood vessel's (e.g., radial artery) vicinity. This brief analyzed multiple linearizing front ends for the GMR-magnet system. GMR based analog front end's (AFE) gain requirement is derived through COMSOL and MATLAB-based simulation considering the raw signal data. After that, we designed a fully differential difference amplifier (FDDA) in 0.18 µm, 1.8 V process using the SPICE environment for amplification of MPG signals. An automatic calibration method is used for compensating the GMR sensor's offset and lowering it to a few µV level during constant current excitation. This proposed GMR-magnet system is a stepping stone towards noninvasive arterial pulse waveform (APW) detection using the MPG principle, with or without direct skin contact. The DDA achieves open and closed-loop gain of 102 dB and 32 dB, phase margin of 62◦, an IRN of 1.8µV, and a unity-gain frequency of 32kHz, resulting in a closed-loop bandwidth of 800 Hz while dissipating 1.2 µA from a 1.8-V supply.

Modelling and Fabrication of a Multi-Modal Highly Sensitive Pressure Sensor

Flexible and skin mountable wearable health monitoring devices have gained much attention in recent years due to their non-invasive approach to continuous monitoring of weak human physiological signals. With applications such as pulse detection and electronic skin, the potential usage of the highly sensitive pressure sensor is more significant than before. In general, ultra-sensitive pressure sensors can be categorized by the operation mechanism into piezoresistive, capacitive, triboelectric, and piezoelectric sensors. Because all these mechanisms require a flexible substrate for their process, combining different sensing mechanisms leads to one multi-mechanism sensor with compounded advantages and diminished shortcomings. In this study, a multimodal sensor (combining piezoresistive, capacitive, and strain gauge modes of operation) with optimized parameters for precise monitoring of arterial pulse waveform has been proposed to allow detection of not only the pulse but also possible irregularities in its waveform that can be potentially the harbingers of various medical conditions. Finite element analysis was employed to establish the design rules for a highly sensitive piezoresistive sensor and also design rules for a micropatterned dialectic layer were developed and after the fabrication of both sensors, they were merged to form a compact multi-mechanism sensing platform. Moreover, fabrication of breathable polymeric substrate has been accomplished by methods such as electrospinning, sacrificial template, and electrostatic spray deposition to ensure long term comfortable wearability of the device. After the fabrication, this capacitive sensor was used to detect the human pulse from the wrist. Also, using bi-polar electrochemistry porous graphene was deposited on the polymeric foundation as the conductive sensing material for the piezoresistive sensor.Furthermore, the results form modelling showed that smaller feature size, lower number density, and a pyramid angle of about 60 degrees of microfeatures improve the sensitivity of the sensor. And finally, the fabrication of the multi-mechanism sensor followed the standard microfabrication techniques including photolithography and transfer printing method to integrate heterogeneous elements into the sensor. The detailed results will be discussed during the presentation.

Self-Powered, Ultrathin, and Transparent Printed Pressure Sensor for Biosignal Monitoring

Ultrathin sensing devices utilizing piezoelectric materials have emerged as potential candidates to develop highly skin-conformable and energy-efficient continuous biosignal monitoring systems. However, biocompatible, cost-efficient, and simple fabrication processes still need to be investigated to enable wider adoption of such devices. This study proposes a simple two-step printing process for the fabrication of a piezoelectric biosignal sensor that utilizes readily available and biocompatible polymer-based materials for the substrate (i.e., Parylene-C), electroactive layer (i.e., poly(vinylidene fluoride-trifluoroethylene) (PVDF-TrFE)), and interdigitated electrodes (i.e., poly(3,4-ethylenedioxythiophene):poly(styrenesulfonate) (PEDOT:PSS)). The proposed interdigitated electrode architecture improves upon the conventional metal–insulator–metal architecture by (1) increasing the thickness-normalized output voltage and (2) enabling the detection of bending orientation. The performance of the proposed sensor structure is demonstrated with the measurement of the arterial pulse waveform signal and limb movement detection. The presented results pave the way for cost-effective and continuous unobtrusive on-skin biosignal monitoring.

Development of a Hybrid Force-Displacement Sensor Based on Fiber Bragg Grating for Radial Artery Pulse Waveform Measurement

This paper proposes a novel Fiber Bragg Grating (FBG)-based hybrid force and displacement sensor with a high sensitivity to achieve accurate measurement of radial artery pulse waveforms. The proposed sensor prototype mainly consists of a force-sensitive orthogonal planar spring structure, an FBG optical fiber, and a sensor frame. The side-type orthogonal planar spring flexure has been utilized and optimized to achieve an excellent linear force-displacement relationship along the axial direction. It offers other merits in terms of equivalent functions as a parallel mechanism configuration, compactness, and convenient assembly. The employed optical fiber has been tightly stretched to form a suspended configuration vertical to the flexure’s central line. This two-point pasting configuration and the use of the transverse movement property of the suspended fiber can achieve improved sensitivity and resolution, and avoid shortcomings associated with the traditional and direct pasting for the whole FBG element. The theoretical model that corresponds to the sensing principle has been derived. The simulation based on finite element method (FEM) has been adopted to conduct design optimization to determine detailed structural parameters and achieve enhanced sensitivity, as well as performance investigation. The optimized prototype has demonstrated an excellent force resolution of 0.47mN with a small linearity error of 0.98% within the sensing range [0.9N, 2.7N] and a high displacement sensitivity of <inline-formula xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"> <tex-math notation="LaTeX">$0.103\mu \text{m}$ </tex-math></inline-formula> with a linearity error of 4.08% within the sensing range [0.3mm, 0.7mm], and the R <sup xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">2</sup> values are determined as 99.99% and 99.30%, respectively. The experiments for artery pulse waveform measurement have been performed to validate the effectiveness of the proposed sensor design.

Recognition of dicrotic notch in arterial blood pressure pulses using signal processing techniques

The Physiological condition of cardiovascular system is analyzed by arterial blood pressure pulse wave. The arterial pulse wave displays the genetic traits of the heart, average records of a heartbeat and variation in pressure as the heart spouts blood. This pulse monitoringis a standard process used to assess the cardiovascular system’s medical history. A waveform ofthe Arterial blood pressure usually involves a systolic level, diastolic occurrence, and dicrotic spike and dicrotic notch. The cardiac cavity contracting and relaxing leads to systolic and diastolic blood pressure respectively. The dicrotic notch which is a drop on the down slope shows systole termination and depicts the aorta closure of successive backward stream. The position of the dicrotic notch throughout the cardiac activity differs as per the duration of aortic closure. Dicrotic notch plays an essential part in sclerosis, occlusion, stenosis, arterial spasm and erythromelalgia diagnostic test. Hence Discrete Wavelet transform is utilized in this proposed work to examine and assess the dicrotic notch in arterial pulse wave form. Arterial pulse data are processed using a data acquisition system consisting of multiple channels sensor signal processing and a computer to collect the necessary data for future examination. The uniform peer group of 22 patients has been evaluated utilizing two distinct Haar and Daubuchies4 (db4) wavelet transformations. The peripheral wave in the patients seems to have a sharp rise and a notch on dropping slope, has been identified. The data collected are contrasted between the two techniques, and the Haar wavelet is observed to reasonably represent the best outcome.

P.99 Empowering midwives with arterial-line management

Introduction: Arterial pulse waveform analysis provides beat- to-beat monitoring of maternal cardiac output and is increasingly utilised in the management of obstetric patients. Common indications include preeclampsia, haemorrhage, obesity or cardiac disease. Such patients would ordinarily be managed in a high dependence or critical care area and 18% of women cared for in our obstetric high dependency unit required invasive arterial monitoring. We observed varying degrees of comfort amongst midwifery staff on managing arterial lines and sought to formally assess this.

Cardiovascular "Patterns" of H2S and SSNO--Mix Evaluated from 35 Rat Hemodynamic Parameters.

This work is based on the hypothesis that it is possible to characterize the cardiovascular system just from the detailed shape of the arterial pulse waveform (APW). Since H2S, NO donor S-nitrosoglutathione (GSNO) and their H2S/GSNO products (SSNO−-mix) have numerous biological actions, we aimed to compare their effects on APW and to find characteristic “patterns” of their actions. The right jugular vein of anesthetized rats was cannulated for i.v. administration of the compounds. The left carotid artery was cannulated to detect APW. From APW, 35 hemodynamic parameters (HPs) were evaluated. H2S transiently influenced all 35 HPs and from their cross-relationships to systolic blood pressure “patterns” and direct/indirect signaling pathways of the H2S effect were proposed. The observed “patterns” were mostly different from the published ones for GSNO. Effect of SSNO−-mix (≤32 nmol kg−1) on blood pressure in the presence or absence of a nitric oxide synthase inhibitor (L-NAME) was minor in comparison to GSNO, suggesting that the formation of SSNO−-mix in blood diminished the hemodynamic effect of NO. The observed time-dependent changes of 35 HPs, their cross-relationships and non-hysteresis/hysteresis profiles may serve as “patterns” for the conditions of a transient decrease/increase of blood pressure caused by H2S.

Pulse Wave Modeling Using Bio-Impedance Simulation Platform Based on a 3D Time-Varying Circuit Model.

Cardiovascular disease (CVD) threatens the lives of many and affects their productivity. Wearable sensors can enable continuous monitoring of hemodynamic parameters to improve the diagnosis and management of CVD. Bio-Impedance (Bio-Z) is an effective non-invasive sensor for arterial pulse wave monitoring based on blood volume changes in the artery due to the deep penetration of its current signal inside the tissue. However, the measured data are significantly affected by the placement of electrodes relative to the artery and the electrode configuration. In this work, we created a Bio-Z simulation platform that models the tissue, arterial pulse wave, and Bio-Z sensing configuration using a 3D circuit model based on a time-varying impedance grid. A new method is proposed to accurately simulate the different tissue types such as blood, fat, muscles, and bones in a 3D circuit model in addition to the pulsatile activity of the arteries through a variable impedance model. This circuit model is simulated in SPICE and can be used to guide design decisions (i.e. electrode placement relative to the artery and electrode configuration) to optimize the monitoring of pulse wave prior to experimentation. We present extensive simulations of the arterial pulse waveform for different sensor locations, electrode sizes, current injection frequencies, and artery depths. These simulations are validated by experimental Bio-Z measurements.

IWRAP: A Theranostic Wearable Device With Real-Time Vital Monitoring and Auto-Adjustable Compression Level for Venous Thromboembolism

Venous Thromboembolism (VTE) is a commonly underdiagnosed disease with severe consequences and an exceedingly high mortality rate. Conventional compression wraps are devised for therapeutic purpose but lack diagnostic capacity. Recent advances in flexible electronics and wearable technologies offer many possibilities for chronic disease management. In particular, vital signs have been studied to show a strong correlation with the risk of VTE patients. In this study, we aim to develop an intelligent theranostic compression device, referred to as iWRAP, with the built-in capacity of real-time vital sign monitoring together with auto-adjustable compression level. An instantaneous pneumatic feedback control with a high-resolution pressure sensor is integrated to provide a highly stabilized compression level at the prescribed interface pressure for an improved therapeutic outcome. Meanwhile, arterial pulse waveforms extracted from the pressure readings from the smart compression device can be utilized to derive the body vital signs, including heart rate (HR), respiratory rate (RR) and blood pressure (BP). A reliable delivery of the targeted compression level within ±5% accuracy in the range of 20-60 mmHg has been achieved through the feedback of the interface pressure. Both HR and RR have been measured within clinical-grade accuracies. Moreover, BP estimated using an ALA model has been achieved at low compression levels, which is also within a clinical-acceptable accuracy. The acquired vital information has been instantaneously fit into the clinically acceptable criteria for life-threatening PE risk with timely assessments. The iWRAP has shown the potential to become the first theranostic wearable device with both continuous delivery of accurate and effective compression therapy and real-time monitoring of life-threatening conditions for VTE patients.

Tracking of brachial and central aortic systolic pressure over the normal human lifespan: insight from the arterial pulse waveforms.

Despite multiple studies, it has not been possible to account for the normal changes of blood pressure that occur from infancy to old age. We sought a comprehensive explanation, by linking brachial pressure with the well documented changes in the arterial pulse waveform, whose peak and nadir determine systolic, diastolic and pulse pressure in brachial arteries. Changes in humans arterial pulse wave contour from birth to old age can be readily explained on (i) growth, with increasing length of the body from birth to adolescence, and adult height maintained thereafter, and (ii) degeneration and dilation of the aorta from elastic fibre fracture throughout life, causing progressive increase in aortic pressure wave amplitude from early return of wave reflection, and summation of incident with reflected waves in systole. These changes throughout life complement arterial pulse waveform analysis and explain brachial cuff pressure values, with optimal pulse wave pattern for cardiac interaction apparent in adolescence.

Multifunctional interlocked e-skin based on elastic micropattern array facilely prepared by hot-air-gun

Electronic skin (e-skin) based on elastic piezoresistive sensor is considered to be one of the most important components for future wearable electronic devices, whose performances can be substantially improved by shaping patterned surface. However, most patterned surfaces are generally fabricated via some tedious methods. Obviously, it is still a huge challenge to realize high sensing performance via facile fabrication process. Here, an efficient but facile method named hot-air-gun assisted preparation is proposed, which enable quasi-hemispherical micropatterned array to be directly fabricated on the single-walled carbon nanotubes (SWCNTs)/thermoplastic polyurethane (TPU) film. The interlocked micropatterns can significantly improve the sensing performance of the as-prepared e-skin based on such micropatterned film, endowing it with very fast response time (<46 ms), wide working range (0.055–254.8 kPa) and excellent durability (>20000 cycles). Interestingly, the interlocked e-skin exhibits multifunction to simultaneously discriminate pressure–temperature stimuli. Moreover, it can monitor a variety of human physiological signals (e.g., arterial pulse waveform, voice recognition and human breathing behavior), indicating a promising application in human–machine interaction. Furthermore, the as-prepared interlocked e-skin could be connected to a wireless transmitter for wireless monitoring respiratory rates. Considering the facile preparation process and the low-cost raw materials, this approach can be easily scaled up for practical production.

The association between indices of blood pressure waveforms (PTC1 and PTC2) and incident heart failure.

The radial artery pulse waveform is a continuous measure of pressure throughout the cardiac cycle, and thus can provide more information than just systolic and diastolic blood pressures. New indices based on a Windkessel model of the waveform, PTC1 and PTC2, are related to arterial compliance and add information for prediction of incident cardiovascular disease (coronary heart disease, stroke, myocardial infarction) but their association with heart failure is unknown. Among 6229 adults (mean age 62 years) from four race/ethnic groups who were initially free of clinical cardiovascular disease and heart failure in 2000-2002, we evaluated the associations of baseline PTC1 and PTC2 with incident heart failure. Mean ± standard deviation PTC1 and PTC2 were 394 ± 334 and 94 ± 46 ms, respectively. During a median of 15.7 years follow-up, there were 357 heart failure events (148 with reduced, 150 with preserved, and 59 with unknown ejection fraction). After adjustment for traditional risk factors, the hazard ratio for heart failure per 1 standard deviation higher PTC2 was 0.73 (95% confidence interval: 0.63--0.85). Higher PTC2 was also significantly associated with lower risk of heart failure with reduced ejection fraction (hazard ratio = 0.67; 95% confidence interval: 0.56--0.80). There was no evidence of a significant association between PTC2 and heart failure with preserved ejection fraction or between PTC1 and heart failure. The PTC2 measure of the radial artery pulse waveform may represent a novel phenotype related to heart failure, especially heart failure with reduced ejection fraction.

Simple method to distinguish the type of fetal premature contraction using arterial Doppler time interval measurements.

AimThe purpose of this study was to establish a simple method to distinguish premature ventricular contractions (PVC) from premature atrial contractions (PAC) using a fetal Doppler ultrasound arterial pulse waveform to measure time intervals between sinus node restarting.MethodsWe retrospectively identified 14 fetuses with premature contraction (8 with PAC, 6 with PVC). We measured two distinct parts of time intervals using an arterial pulsed‐wave Doppler: the two consecutive waveforms just before the premature contraction (2‐V interval) and two consecutive waveforms including the premature contraction (XV interval) to measure time intervals between sinus node restarting. We then evaluated the time difference between the 2‐V and XV intervals in PVC compared to PAC.ResultsFor PVC, the difference between the 2‐V interval and the XV interval was significantly shorter than that for PAC. A cut‐off point of 33 ms, where a difference ≤33 ms was clearly shown to be associated with a PVC and a difference more than 33 ms signified a PAC was demonstrated.ConclusionThe 2‐V and XV interval measurements, used to measure time intervals between sinus node restarting, could easily distinguish PVC from PAC in utero. Therefore, this study could potentially be a feasible and effective method for obstetricians or sonographers to employ usefully.

Properties of Systolic Blood Pressure and Systolic time of Arterial Pulse Waveform According to Thermal Effect of the Upper body by Using the Shoulder Heat Therapy

Properties of Systolic Blood Pressure and Systolic time of Arterial Pulse Waveform According to Thermal Effect of the Upper body by Using the Shoulder Heat Therapy

Rapid declines in systolic blood pressure are associated with an increase in pulse transit time.

The correlation between pulse transit time and blood pressure has been proposed as a route to measure continuous non-invasive blood pressure. We investigated whether pulse transit time trends could model blood pressure trends during episodes of rapid declines in blood pressure. From the Medical Information Mart for Intensive Care waveform database we identified substantial blood pressure reductions. Pulse transit time was calculated from the R-peak of the electrocardiogram to the peak of the arterial pulse waveform. The time-series were processed with a moving average filter before comparison. Averaged, continuous heart rate was also analysed as a control. The intra-individual association between variables was assessed per subject using linear regression. In the 511 patients included we found a median correlation coefficient between blood pressure and pulse transit time of -0.93 (IQR -0.98 to -0.76) with regression slopes of -1.23 mmHg/ms (IQR -1.73 to -0.81). The median correlation coefficient between blood pressure and heart rate was 0.46 (IQR -0.16 to 0.83). In supplementary analysis, results did not differ substantially when widening inclusion criteria, but the results were not always consistent within subjects across episodes of hypotension. In a large cohort of critically ill patients experiencing episodes of rapid declines in systolic blood pressure, there was a moderate-strong intra-individual correlation between averaged systolic blood pressure and averaged pulse transit time. Our findings encourage further investigation into using the pulse transit time for non-invasive real-time detection of hypotension.

Increased augmentation index in patients with Ehlers-Danlos syndrome

BackgroundEhlers-Danlos Syndrome (EDS) comprises a heterogeneous group of diseases characterized by joint hypermobility, connective tissue friability, and vascular fragility. Reliable prognostic factors predicting vascular disease progression (e.g. arterial aneurysms, dissections, and ruptures) in EDS patients are still missing. Recently, applanation tonometry derived augmentation index (AIx), an indirect marker of arterial stiffness, has shown to be positively associated with progression of aortic disease in Marfan syndrome. In this study, we assessed aortic AIx in patients with EDS and matched healthy controls.MethodsWe performed noninvasive applanation tonometry in 61 adults with EDS (43 women and 18 men aged 39.3 ± 14.6 years) and 61 age-, gender-, height-, and weight-matched healthy controls. Radial artery pulse waveforms were recorded and analyzed using the SphygmoCor System (AtCor Medical, Sydney, NSW, Australia). Calculated AIx was adjusted to a heart rate of 75/min. Groups were compared and association between AIx and EDS was determined by univariate and multivariate regression analysis.ResultsEDS patients were categorized in classical type EDS (34%), hypermobile type EDS (43%), vascular type EDS (5%), or remained unassignable (18%) due to overlapping features. EDS patients showed a significantly increased aortic AIx compared to healthy controls (22.8% ± 10.1 vs 14.8% ± 14.0, p < 0.001). EDS showed a positive association with AIx; independent of age, sex, height, blood pressure, medication, and pack years of smoking.ConclusionsPatients with EDS showed elevated AIx, indicating increased arterial stiffness when compared to healthy controls. Further investigations are needed in order to assess the prognostic value of increased AIx for cardiovascular outcomes in patients with EDS.