Evaluation of the carotid artery using wavelet-based analysis of the pulse wave signal

<p>The use of pulse wave analysis may assist cardiologists in diagnosing patients with vascular diseases. However, it is not common in clinical practice to interpret and analyze pulse wave data and utilize them to detect the abnormalities of the signal. This paper presents a novel approach to the clinical application of pulse waveform analysis using the wavelet technique by decomposing the normal and pathology signal into many levels. The discrete wavelet transform (DWT) decomposes the carotid arterial pulse wave (CAPW) signal, and the continuous wavelet transform (CWT) creates images of the decomposed signal. The wavelet analysis technique in this work aims to strengthen the medical benefits of the pulse wave. The obtained results show a clear difference between the signal and the images of the arterial pathologies in comparison with normal ones. The certain distinct that were achieved are promising but further improvement may be required in the future.</p>

Cardiopulmonary Function Assessment in Children With Pulmonary Valve Stenosis

ObjectivePulmonary valve (PV) stenosis affects cardiac pulmonary function and exercise performance. A cardiopulmonary exercise test (CPET) combined with a transthoracic echocardiogram (TTE) can measure exercise performance, disease progression, and treatment effects. We assessed the exercise capacity in children with PV stenosis by conducting CPET and TTE.MethodsFrom 2005 to 2021, 84 patients with PV stenosis aged 6–18 years were enrolled; 43 were treated with balloon pulmonary valvuloplasty (BPV) (Group A), and 41 received follow-up care (Group B), and their CPET and pulmonary function test results were compared with 84 healthy, matched individuals (Control). We also conducted TTE to compare the peak pulmonary artery pulse wave velocity and pulmonary valve (PV) area before and after catheterization and follow-up care.ResultsThere were no significant differences among the CPET parameters of the patient groups and controls in anaerobic metabolic equivalent (MET) (group A: 6.44 ± 0.58; group B: 6.28 ± 0.47, control: 6.92 ± 0.39, p = 0.110), peak MET (group A: 9.32 ± 0.74; group B: 9.13 ± 0.63; control: 9.80 ± 0.52, p = 0.263), and heart rate recovery (group A: 28.04 ± 4.70; group B: 26.44 ± 3.43, control:26.10 ± 2.42, p = 0.718). No significant differences were found in the pulmonary functions between the three groups. The pulmonary artery pulse wave velocity significantly decreased after catheterization (3.97 ± 1.50 vs. 1.95 ± 0.94, p &lt; 0.0001), but not after follow-up care (1.67 ± 0.77 vs. 1.75 ± 0.66, p = 0.129). The pulmonary vale area significantly improved in group A (0.89 ± 0.71 vs. 1.16 ± 0.58, p &lt; 0.0001), whereas only insignificant progression of PV stenosis was observed in group B (1.60 ± 0.64 vs. 1.57 ± 0.65, p = 0.110).ConclusionsPatients treated with BPV had a similar exercise capacity with that of patients under follow-up care and the healthy controls. Larger or multi-center studies should be conducted to confirm the physical fitness of pediatric patients with PV stenosis after management.

Effect of Acupuncture on Artery Elasticity for Atherosclerosis: A Randomized Controlled Trial

Background Atherosclerosis (AS) is a chronic arterial disease. Atherosclerosis related diseases, like myocardial infarctions (MI) and strokes have the highest mortality and disability rate. However, limited evidence verified the effects of acupuncture on arterial stiffness for subclinical atherosclerosis. We hypothesized that acupuncture could improve arterial stiffness in subclinical atherosclerosis and resist plaque progression. The aim of this study is to assess the effect of acupuncture on arterial elasticity via ultrafast pulse wave velocity (ufPWV) and explore the effect of acupuncture on lipid level and platelet function for subclinical atherosclerosis patients.MethodsThis was a randomized parallel controlled trial included 44 patients. Patients were assigned in a 1:1 ratio to acupuncture group and sham acupuncture group. Patients completed 24 treatments in total within 12 weeks of intervention. The primary outcome was ultrafast pulse wave velocity (ufPWV) assessed after every 4-weeks treatment; the secondary outcomes were carotid intima-media thickness (cIMT), blood lipid levels, fibrinogen (FIB) and blood platelet. Intention-to-treat (ITT) principle was applied and data sets were analyzed using SPSS 20.0 software.ResultsAmong the 44 randomly assigned patients, changes of right-side BS value in TA group (0.841) at week 12 were greater than SA group (-0.189), with a mean difference of 1.030 (95% CI, 0.320, 1.739; P=0.006). Similar results were observed in right-side ES, left-side BS, left-side ES at week 12. As to secondary outcomes, compared with SA group(1.08mm), the TA group(0.98mm) showed a significant decline in mean of left-side IMT at week 12. (Z= -2.118; P=0.034). There were no serious adverse events.ConclusionsAmong patients with Carotid intima-media thickening, both-side carotids arterial elasticity is significantly improved after 12-week acupuncture compared with sham acupuncture. The effects of acupuncture are more noticeable at week 12 during end-systole.Trial registrationThe trial was registered at http://www.chictr.org.cn (NO. ChiCTR1900025551, 31/08/2019)

NGHIÊN CỨU MỐI LIÊN QUAN GIỮA CHỈ SỐ ABI, TỐC ĐỘ LAN TRUYỀN SÓNG MẠCH VỚI MỨC ĐỘ TỔN THƯƠNG ĐỘNG MẠCH VÀNH THEO THANG ĐIỂM SYNTAX II Ở BỆNH NHÂN NHỒI MÁU CƠ TIM CẤP

Mục tiêu: Tìm hiểu mối liên quan giữa chỉ số huyết áp tâm thu cổ chân-cánh tay (Ankle Brachial Index – ABI), tốc độ lan truyền sóng mạch (pulse wave velocity - PWV) với mức độ tổn thương động mạch vành (ĐMV) ở bệnh nhân (BN) nhồi máu cơ tim (NMCT) cấp. Đối tượng và phương pháp nghiên cứu: Nghiên cứu mô tả cắt ngang trên 2 nhóm: nhóm bệnh gồm 60 người bị NMCT cấp và nhóm chứng gồm 33 người có cùng độ tuổi và các yếu tố nguy cơ và chụp ĐMV không tổn thương. Cả 2 nhóm đều được đo ABI, PWV, chụp ĐMV, nhóm bệnh được đánh giá mức độ tổn thương theo thang điểm SYNTAX II. Kết quả: Tuổi trung bình của nhóm bệnh và nhóm chứng tương ứng là 67,05 ± 12,04 và 67,67 ± 6,80 năm. ABI của nhóm bệnh (1,04 ± 0,10) thấp hơn nhóm chứng (1,12 ± 0,13), p<0,01. PWV của nhóm bệnh (15,90 ±1,49 m/s) cao hơn nhóm chứng (13,32 ± 1,98 m/s), p<0,01. PWV ở nhóm tổn thương 1 nhánh và ≥2 nhánh tương ứng là 15,25 ± 1,09 m/s và 16,22 ± 1,57 m/s. Có sự tương quan chặt chẽ giữa PWV với điểm SYNTAX (r = 0,477; p<0,01). Kết luận: ở nhóm NMCT cấp PWV cao hơn và ABI thấp hơn nhóm chứng có ý nghĩa. PWV tương quan chặt chẽ với mức độ tổn thương ĐMV theo thang điểm SYNTAX II.

ĐÁNH GIÁ ĐỘ CỨNG ĐỘNG MẠCH BẰNG CHỈ SỐ VẬN TỐC LAN TRUYỀN SÓNG MẠCH (PULSE WAVE VELOCITY - PWV) Ở BỆNH NHÂN BỊ BỆNH ĐỘNG MẠCH VÀNH MẠN TÍNH

Mục tiêu: Đánh giá độ cứng động mạch bằng chỉ số vận tốc lan truyền sóng mạch (pulse wave velocity - PWV) ở bệnh nhân (BN) bị bệnh động mạch vành mạn tính (BĐMVMT). Đối tượng và phương pháp: Nhóm bệnh gồm 61 người bị BĐMVMT được chẩn đoán xác định bằng phương pháp chụp động mạch vành qua da có hẹp ≥50% đường kính lòng mạch và nhóm chứng gồm 31 người nghi ngờ bị BĐMVMT nhưng chụp động mạch vành không tổn thương hoặc tổn thương <50%. Cả 2 nhóm đều được đo PWV. Kết quả: Tuổi trung bình của nhóm chứng và nhóm bệnh lần lượt là 68,26 ± 6,66 và 70,1 ± 7,15 năm. Tuổi ≥65 chiếm tỷ lệ cao (nhóm chứng và nhóm bệnh lần lượt là 74,2%; 77,0%). Nhóm bệnh nam chiếm tỷ lệ cao (60,7%) hơn nữ (39,3%). PWV tăng (≥14 m/s) ở nhóm bệnh và nhóm chứng tương ứng là: Bên phải (82,0%; 32,3%). Bên trái (67,2%; 22,6%) p<0,05. PWV ở người bị THA của nhóm bệnh và chứng tương ứng là: 15,05 ± 0,61 m/s; 11,47 ± 1,53 m/s, ở người bị ĐTĐ: 15,89 ± 2,07 m/s; 14,06 ± 1,29 m/s, người hút thuốc lá: 15,76 ± 1,97; 13,82 ± 1,45 m/s, người thừa cân: 15,69 ± 1,79 m/s; 13,59 ± 2,12m/s. Kết luận: Nhóm bệnh có PWV tăng (≥14 m/s) chiếm tỷ lệ cao hơn nhóm chứng. Ở cùng độ tuổi, giới tính và các yếu tố nguy cơ (THA, ĐTĐ, hút thuốc lá, thừa cân) thì PWV ở nhóm bệnh đều cao hơn ở nhóm chứng có ý nghĩa thống kê với p<0,05.

Utility of estimated pulse wave velocity for assessing vascular stiffness: comparison of methods

Aim. Pulse wave velocity independently predicts cardiovascular risk. Easy to use single cuff oscillometric methods are utilized in clinical practice to estimate pulse wave velocity. We applied the approach in master athletes to assess possible beneficial effects of lifelong exercise on vascular health. Furthermore, we compared single cuff measurements with a two-cuff method in another cohort. Methods. We obtained single cuff upper arm oscillometric measurements thrice in 129 master athletes aged 35 to 86 years and estimated pulse wave velocity using the ArcSolver algorithm. We applied the same method in 24 healthy persons aged 24 to 55 years participating in a head down tilt bedrest study. In the latter group, we also obtained direct pulse wave velocity measurements using a thigh cuff.Results. Estimated pulse velocity very highly correlated with age (R2 = 0.90) in master athletes. Estimated pulse wave velocity values were located on the same regression line like values obtained in participants of the head down tilt bed rest study. The modest correlation between estimated and measured PWV (r² 0.40; p<0.05) was attenuated after adjusting for age; the mean difference between pulse wave velocity measurements was 1 m/s.Conclusion. Estimated pulse wave velocity mainly reflects the entered age rather than true vascular properties and, therefore, failed detecting beneficial effects of life long exercise.Funding. The AGBRESA-Study was funded by the German Aerospace Center (DLR), the European Space Agency (ESA, contract number 4000113871/15/NL/PG) and the National Aeronautics and Space Administration (NASA, contract number 80JSC018P0078). Fabian Hoffmann received funding by the DLR and the German Federal Ministry of Economy and Technology, BMWi (50WB1816). SM, JT and JJ were supported by the Austrian Federal Ministry for Climate Action, Environment, Energy, Mobility, Innovation and Technology, BMK (SPACE4ALL Project, FFG No. 866761).

Usefulness of estimated pulse wave velocity for identifying prevalent coronary heart disease: findings from a general Chinese population

Background Aortic stiffness and coronary heart disease (CHD) share a similar spectrum of risk factors; previous studies have identified the association between aortic stiffness and CHD. Recent studies have demonstrated estimated pulse wave velocity (ePWV) as a simple and easy-acquired indicator of aortic stiffness. Our work aims to evaluate the association between ePWV and the prevalence of CHD and assess the value of ePWV for the identification of prevalent CHD. Methods The current cross-sectional work included 7012 subjects from rural areas of southeastern China between September 2020 and February 2021. ePWV was calculated from age and mean blood pressure by specific algorithm. Results The prevalence of CHD in our population was 3.58% (251 patients among 7012 subjects). After adjusting for age, sex, education, income and exercise level, current smoking and drinking status, body mass index, waist circumference, fasting plasma glucose, total cholesterol, high density lipoprotein, estimated glomerular filtration rate and cerebrovascular diseases, each standard deviation increment of ePWV would produce an additional 37.8% risk of prevalent CHD. Moreover, after dividing ePWV into quartiles, the 4th quartile of ePWV showed a significant risk of prevalent CHD (OR (95% CI): 3.567 (1.963–6.479)) when compared with the 1st quartile. Additionally, the subgroup analysis showed the association between ePWV and prevalent CHD was robust to several common risk factors of CHD, including age, sex, body mass index, hypertension, diabetes and reduced estimated glomerular filtration rate. Finally, the area under curve (AUC) displayed an improvement when adding ePWV into common CHD risk factors (0.705 vs. 0.718. P = 0.044). Consistently, net reclassification index (0.436, 95% CI: 0.301–0.571, P < 0.001) and integrated discrimination index (0.004, 95% CI: 0.001–0.006, P = 0.002) demonstrated the value of ePWV to optimize the identification of prevalent CHD in the general population. Conclusion The present analysis implicates the robust association between ePWV, a simple, rapid, and practical marker of aortic stiffness, and prevalent CHD in the general Chinese population. More importantly, the results suggest the value of ePWV as a potential marker to improve the identification of prevalent CHD.