Obeid Hasan, Khettab Hakim, Marais Louise, Hallab Magid, Laurent Stéphane, Boutouyrie Pierre
aINSERM-PARCC U970 bDepartment of Pharmacology and Hôpital Européen Georges Pompidou, Paris cGerontology Department, Nantes University, Nantes dAxelife SAS, Saint Nicolas de Redon eUniversité Paris-Descartes, Assistance-Publique Hôpitaux de Paris, Paris, France.
J Hypertens. 2017 Aug;35(8):1618-1625. doi: 10.1097/HJH.0000000000001371.
Carotid-femoral pulse wave velocity (PWV) (cf-PWV) is the gold standard for measuring aortic stiffness. Finger-toe PWV (ft-PWV) is a simpler noninvasive method for measuring arterial stiffness. Although the validity of the method has been previously assessed, its accuracy can be improved. ft-PWV is determined on the basis of a patented height chart for the distance and the pulse transit time (PTT) between the finger and the toe pulpar arteries signals (ft-PTT).
The objective of the first study, performed in 66 patients, was to compare different algorithms (intersecting tangents, maximum of the second derivative, 10% threshold and cross-correlation) for determining the foot of the arterial pulse wave, thus the ft-PTT. The objective of the second study, performed in 101 patients, was to investigate different signal processing chains to improve the concordance of ft-PWV with the gold-standard cf-PWV. Finger-toe PWV (ft-PWV) was calculated using the four algorithms.
The best correlations relating ft-PWV and cf-PWV, and relating ft-PTT and carotid-femoral PTT were obtained with the maximum of the second derivative algorithm [PWV: r = 0.56, P < 0.0001, root mean square error (RMSE) = 0.9 m/s; PTT: r = 0.61, P < 0.001, RMSE = 12 ms]. The three other algorithms showed lower correlations. The correlation between ft-PTT and carotid-femoral PTT further improved (r = 0.81, P < 0.0001, RMSE = 5.4 ms) when the maximum of the second derivative algorithm was combined with an optimized signal processing chain.
Selecting the maximum of the second derivative algorithm for detecting the foot of the pressure waveform, and combining it with an optimized signal processing chain, improved the accuracy of ft-PWV measurement in the current population sample. Thus, it makes ft-PWV very promising for the simple noninvasive determination of aortic stiffness in clinical practice.
颈股脉搏波速度（PWV）（cf-PWV）是测量主动脉僵硬度的金标准。指趾脉搏波速度（ft-PWV）是一种更简单的测量动脉僵硬度的非侵入性方法。尽管该方法的有效性此前已得到评估，但其准确性仍可提高。ft-PWV是根据专利高度图确定手指与趾部掌侧动脉信号之间的距离和脉搏传播时间（PTT）（ft-PTT）来测定的。
第一项研究纳入66例患者，目的是比较不同算法（相交切线法、二阶导数最大值法、10%阈值法和互相关法）来确定动脉脉搏波的波谷，从而确定ft-PTT。第二项研究纳入101例患者，目的是研究不同的信号处理链，以提高ft-PWV与金标准cf-PWV的一致性。使用这四种算法计算指趾脉搏波速度（ft-PWV）。
使用二阶导数最大值法获得了ft-PWV与cf-PWV以及ft-PTT与颈股PTT之间的最佳相关性[PWV：r = 0.56，P < 0.0001，均方根误差（RMSE）= 0.9 m/s；PTT：r = 0.61，P < 0.001，RMSE = １２ ms]。其他三种算法的相关性较低。当二阶导数最大值法与优化后的信号处理链相结合时，ft-PTT与颈股PTT之间的相关性进一步提高（r = 0.81，P < 0.0001，RMSE = 5.4 ms）。
选择二阶导数最大值法来检测压力波形的波谷，并将其与优化后的信号处理链相结合，提高了当前人群样本中ft-PWV测量的准确性。因此，这使得ft-PWV在临床实践中用于简单无创测定主动脉僵硬度方面非常有前景。
