Driscoll M D, Arnold J M, Marchiori G E, Sherebrin M H
Department of Medicine, University of Western Ontario, London.
Clin Invest Med. 1995 Dec;18(6):435-48.
Arterial stiffness in hypertension and heart failure may increase afterload on the left ventricle. Pulse wave velocity and transmission ratio measurements are noninvasive methods to assess arterial stiffness. Since noninvasive pressure pulse recording requires sufficient applied force to distort the vessel wall, we hypothesized that the pulse wave velocity, transmission ratios, and distal pulse amplitudes and contours may be altered by the recording technique. Brachial and radial arterial pressure pulses were recorded simultaneously using a piezoelectric pulse transducer in 14 young, normal, male subjects using 10 brachial artery recording forces (0.35-3.58N, approximately equal to 0.36N increments) applied in a random order and a constant radial force (2.35N). Pulses were Fourier analyzed. One subject was excluded from analysis because of improper transducer positioning over the brachial artery. In 8 subjects, no significant changes occurred in any variable over all brachial recording forces. In the remaining 5 subjects, the measured variables remained constant until brachial artery recording forces exceeded 2.42 +/- 0.03N. The pulse wave velocity (p < 0.04), transmission ratios (harmonics 2-5, p < 0.0001), radial pulse amplitude (p < 0.0003), and relative powers (harmonics 2-5, p < 0.02) then decreased. In these subjects, brachial artery depths were less than the other subjects (5.9 +/- 0.4 vs. 7.7 +/- 0.4 mm, p < 0.05). The brachial and radial artery recording forces normally used during clinical measurements by 2 investigators were 1.43 +/- 0.01N (95% confidence intervals (CI) = 1.23N, 1.62N) and 1.88 +/- 0.11N (95% CI = 1.65N, 2.10N), respectively. Therefore, at forces normally used by clinical investigators, the pulse wave velocity, harmonic transmission ratios, and pulse amplitudes and contours obtained at the brachial and radial artery are not significantly influenced by forces applied at the brachial artery. However, these variables may be decreased in subjects with more superficial arteries when higher recording forces are used.
高血压和心力衰竭时的动脉僵硬度可能会增加左心室的后负荷。脉搏波速度和传导比测量是评估动脉僵硬度的无创方法。由于无创压力脉搏记录需要足够的作用力来使血管壁变形，我们推测脉搏波速度、传导比以及远端脉搏振幅和轮廓可能会受到记录技术的影响。在14名年轻、正常的男性受试者中，使用压电脉搏传感器同时记录肱动脉和桡动脉的压力脉搏，对肱动脉施加10种记录力（0.35 - 3.58N，大约以0.36N的增量递增），随机顺序施加，桡动脉施加恒定的力（2.35N）。对脉搏进行傅里叶分析。由于传感器在肱动脉上的位置不当，一名受试者被排除在分析之外。在8名受试者中，所有肱动脉记录力下任何变量均无显著变化。在其余5名受试者中，在肱动脉记录力超过2.42±0.03N之前，测量变量保持恒定。然后，脉搏波速度（p < 0.04）、传导比（谐波2 - 5，p < = 0.0001）、桡动脉脉搏振幅（p < 0.0003）和相对功率（谐波2 - 5，p < 0.02）下降。在这些受试者中，肱动脉深度小于其他受试者（5.9±0.4 vs. 7.7±0.4 mm，p < 0.05）。两名研究者在临床测量中通常使用的肱动脉和桡动脉记录力分别为1.43±0.01N（95%置信区间（CI） = 1.23N，1.62N）和1.88±0.11N（95%CI = 1.65N，2.10N）。因此，在临床研究者通常使用的记录力下，在肱动脉和桡动脉获得的脉搏波速度、谐波传导比以及脉搏振幅和轮廓不会受到肱动脉施加力的显著影响。然而，当使用更高的记录力时，对于动脉较浅的受试者，这些变量可能会降低。
