Key result
Increased arterial stiffness was consistently associated with reduced foot-to-foot pulse transit time, but the ratio of foot-to-foot to peak-to-peak transit times did not significantly differentiate groups.
Why the study?
Does comparing foot-to-foot and peak-to-peak pulse transit time delays differentiate between healthy controls and hypertensive patients?
Observational
Does comparing foot-to-foot and peak-to-peak pulse transit time delays differentiate between healthy controls and hypertensive patients?
While reduced foot-to-foot pulse transit time is associated with arterial stiffness, the ratio of foot-to-foot to peak-to-peak delays did not significantly differentiate hypertensive patients from healthy controls.
Supports further investigation of foot-to-foot transit time for stiffness; leaves open diagnostic value of the ratio in hypertension.
Cardiovascular disease (CVD) is the leading cause of global mortality, with an increasing burden on the populations of low and middle income countries as identified by the World Health Organization. Rapid, noninvasive screening methods for CVD using low-cost technology would allow for better healthcare. Pulse Wave Velocity (PWV) as measured by noninvasive methods such as photoplethysmograph and pressure sensors has been validated as a method for screening for CVD. PWV correlates closely with arterial stiffness, which is a strong indicator of CVD and is calculated using artery length and Pulse Transit Time (PTT) using multiple simultaneous recordings at two superficial arterial sites. While PTT is generally agreed to correlate with CVD, there is still ambiguity concerning the best way to analyze the arterial pulse contour to ascertain patient health. Proper pulse wave analysis could prove to be useful diagnosis of arterial stiffness in patients with hypertension. This analysis studied the efficacy of comparing the foot-to-foot (PTTf) and peak-to-peak (PTTp) delays as a means of differentiating between healthy control patients and hypertensive patients. Wave reflection is thought to affect the PTTp while leaving the PTTf unaffected, so that a comparison should reveal a ratio close to one in healthy patients but a ratio deviated from one in hypertensive patients. The results of this analysis reveal that increased arterial stiffness is consistently associated with reduced PTTf and improved upon anti-hypertensive drug treatment. However the results did not show a statistically significant difference in comparing some of the control and test groups using the ratio of PTTf and PTTp. These results should be further pursued and validated with more detailed analysis, rigid and consistent parameters, and better accounting for wave reflection.
No takes yet. Share an insight, caveat, or question.
Daniel Badger (2016) conducted an observational in Hypertension. Pulse Distortion Index (PDI) measurement vs. Healthy controls was evaluated on Difference in Pulse Distortion Index (ratio of PTTp to PTTf). Increased arterial stiffness was consistently associated with reduced foot-to-foot pulse transit time, but the ratio of foot-to-foot to peak-to-peak transit times did not significantly differentiate groups.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: