TY - JOUR

T1 - Pulse wave travel distance as a novel marker of ventricular-arterial coupling

AU - Obata, Yurie

AU - Ruzankin, Pavel

AU - Gottschalk, Allan

AU - Nyhan, Daniel

AU - Berkowitz, Dan E.

AU - Steppan, Jochen

AU - Barodka, Viachaslau

PY - 2018/3/1

Y1 - 2018/3/1

N2 - Each stroke volume ejected by the heart is distributed along the arterial system as a pressure waveform. How far the front of the pressure waveform travels within the arterial system depends both on the pulse wave velocity (PWV) and the ejection time (ET). We tested the hypothesis that ET and PWV are coupled together, in order to produce a pulse wave travel distance (PWTD = PWV × ET) which would match the distance from the heart to the most distant site in the arterial system. The study was conducted in 11 healthy volunteers. We recorded lead II of the ECG along with pulse plethysmography at ear, finger and toe. The ET at the ear and pulse arrival time to each peripheral site were extracted. We then calculated PWV followed by PWTD for each location. Taken into account the individual subject variability PWTDToe in the supine position was 153 cm (95% CI 146–160 cm). It was not different from arterial pathway distance from the heart to the toe (DToe 153 cm). The PWTDFinger and PWTDEar were longer than the distance from the heart to the finger and ear irrespective of body position. ETEar and PWVToe appear to be coupled in healthy subjects to produce a PWTD that is roughly equivalent to the arterial pathway distance to the toe. We propose that PWTD should be evaluated further to test its potential as a noninvasive parameter of ventricular-arterial coupling in subjects with cardiovascular diseases.

AB - Each stroke volume ejected by the heart is distributed along the arterial system as a pressure waveform. How far the front of the pressure waveform travels within the arterial system depends both on the pulse wave velocity (PWV) and the ejection time (ET). We tested the hypothesis that ET and PWV are coupled together, in order to produce a pulse wave travel distance (PWTD = PWV × ET) which would match the distance from the heart to the most distant site in the arterial system. The study was conducted in 11 healthy volunteers. We recorded lead II of the ECG along with pulse plethysmography at ear, finger and toe. The ET at the ear and pulse arrival time to each peripheral site were extracted. We then calculated PWV followed by PWTD for each location. Taken into account the individual subject variability PWTDToe in the supine position was 153 cm (95% CI 146–160 cm). It was not different from arterial pathway distance from the heart to the toe (DToe 153 cm). The PWTDFinger and PWTDEar were longer than the distance from the heart to the finger and ear irrespective of body position. ETEar and PWVToe appear to be coupled in healthy subjects to produce a PWTD that is roughly equivalent to the arterial pathway distance to the toe. We propose that PWTD should be evaluated further to test its potential as a noninvasive parameter of ventricular-arterial coupling in subjects with cardiovascular diseases.

KW - Arterial pathway distance

KW - Ejection time

KW - Pulse wave travel distance

KW - Pulse wave velocity

KW - Ventricular-arterial coupling

KW - COLLABORATIVE TRIAL ACCT

KW - VELOCITY

KW - RISK-FACTORS

KW - CARDIOVASCULAR EVENTS

KW - TIME

KW - AORTIC AUGMENTATION INDEX

KW - INPUT IMPEDANCE

KW - EXCESS PRESSURE

KW - STIFFNESS

KW - HEART-RATE

UR - http://www.scopus.com/inward/record.url?scp=85030330809&partnerID=8YFLogxK

U2 - 10.1007/s00380-017-1058-4

DO - 10.1007/s00380-017-1058-4

M3 - Article

C2 - 28975398

AN - SCOPUS:85030330809

VL - 33

SP - 279

EP - 290

JO - Heart and Vessels

JF - Heart and Vessels

SN - 0910-8327

IS - 3

ER -