Skip to main content
Log in

Factors that Affect Pulse Wave Time Transmission in the Monitoring of Cardiovascular System

  • Published:
Journal of Clinical Monitoring and Computing Aims and scope Submit manuscript

Abstract

Objectives

Vascular transit time (VTT) can be defined as the first heart sound of the phonocardiography (PCG) signal to its arrival at the photoplethysmography (PPG). Studies have shown that monitoring VTT can be useful as an early prognosis of cardiac diseases. However, there is limited study conducted to understand the physiologic factors that affect VTT at the upper limb. In this study, the effect associated with difference in subject height, weight, heart rate, mean arterial pressure, systolic and diastolic blood pressure was assessed.

Methods

A study population of 31 healthy Chinese young adults (21 male; age range 20–33 yr) were recruited. PCG and PPG were recorded non-invasively from the fourth costal cartilage at the midclavicular line and right index finger, respectively. A single sample Kolmogorov–Smirnov (K–S) goodness-of-fit hypothesis test, a univariate linear regression analysis, and a multiple linear regression modelling were performed on the VTT measurements and the associated physiologic parameters.

Results

The results from the K–S test showed that the physiologic parameters and VTT measurements had a normal cumulative distribution function. Furthermore, all physiologic parameters were significantly and independently related to VTT (< 0.05). Based on these physiological parameters, a VTT regression model was also derived (r 2 = 0.79).

Conclusions

The findings herein suggest that the observed physiologic parameters have significant contributions to the nominal VTT value of a subject. Unlike pulse transit time, the VTT technique has the added advantage that the left ventricular isometric contraction time is not included in the timing derivation.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Millasseau SC, Guigui FG, Kelly RP, Prasad K, Cockcroft JR, Ritter JM, Chowienczyk PJ. Noninvasive assessment of the digital volume pulse. Comparison with the peripheral pressure pulse. Hypertension 2000; 36: 952–956

    PubMed  CAS  Google Scholar 

  2. Wang YYL, Jan MY, Wang GC, Bau JG, Wang WK. Pressure pulse velocity is related to the longitudinal elastic properties of the artery. Physiol Meas 2004; 25: 1397–1403

    Article  PubMed  Google Scholar 

  3. Pitson D, Chhina N, Knijn M, Herwaaden V, Stradling J. Changes in pulse transit time and pulse rate as markers of arousal from sleep in normal subjects. Clin Sci 1994; 87: 269–273

    PubMed  CAS  Google Scholar 

  4. Ahlstrom C, Johansson A, Uhlin F, Lanne T, Ask P. Noninvasive investigation of blood pressure changes using the pulse wave transit time: a novel approach in the monitoring of hemodialysis patients. J Artif Organs 2005; 8: 192–197

    Article  PubMed  Google Scholar 

  5. Payne RA, Symeonides CN, Webb DJ, Maxwell SR. Pulse transit time measured from the ECG: an unreliable marker of beat-to-beat blood pressure. J Appl Physiol 2006; 100: 136–141

    Article  PubMed  CAS  Google Scholar 

  6. Durand LG, Pibarot P. Digital signal processing of the phonocardiogram: review of the most recent advancements. Crit Rev Biomed Eng 1995; 23: 163–219

    PubMed  CAS  Google Scholar 

  7. Durand LG, Blanchard M, Cloutier G, Sabbah HN, Stein PD. Comparison of pattern recognition methods for computer-assisted classification of spectra of heart sounds in patients with a porcine bioprosthetic valve implanted in the mitral position. IEEE Trans Biomed Eng 1990; 37: 1121–1129

    Article  PubMed  CAS  Google Scholar 

  8. Avolio AP, Chen SG, Wang RP, Zhang CL, Li MF, O’Rourke MF. Effects of aging on changing arterial compliance and left ventricular load in a northern Chinese urban community. Circulation 1983; 68: 50–58

    PubMed  CAS  Google Scholar 

  9. Allen J, Murray A. Age-related changes in peripheral pulse timing characteristics at the ears, fingers and toes. J Hum Hypertens 2002; 16: 711–717

    Article  PubMed  CAS  Google Scholar 

  10. Netea RT, Smits P, Lenders JW, Thien T. Does it matter whether blood pressure measurements are taken with subjects sitting or supine? J Hypertens 1998; 16: 263–268

    Article  PubMed  CAS  Google Scholar 

  11. Dupont WD, Plummer WD. PS power and sample size program available for free on the internet. Control Clin Trials 1997; 18: 274

    Article  Google Scholar 

  12. Tsai WC, Chen JY, Wang MC, Wu HT, Chi CK, Chen YK, Chen JH, Lin LJ. Association of risk factors with increased pulse wave velocity detected by a novel method using dual-channel photoplethysmography. Am J Hypertens 2005; 18: 1118–1122

    Article  PubMed  Google Scholar 

  13. Nitzan M, Khanokh B, Slovik Y. The difference in pulse transit time to the toe and finger measured by photoplethysmography. Physiol Meas 2002; 23: 85–93

    Article  PubMed  CAS  Google Scholar 

  14. Zebekakis PE, Nawrot T, Thijs L, Balkestein EJ, van der Heijden-Spek J, Van Bortel LM, Struijker-Boudier HA, Safar ME, Staessen JA. Obesity is associated with increased arterial stiffness from adolescence until old age. J Hypertens 2005; 23: 1839–1846

    Article  PubMed  CAS  Google Scholar 

  15. Balkestein EJ, van Aggel-Leijssen DP, van Baak MA, Struijker-Boudier HA, Van Bortel LM. The effect of weight loss with or without exercise training on large artery compliance in healthy obese men. J Hypertens 1999; 17: 1831–1835

    Article  PubMed  CAS  Google Scholar 

  16. Poulter NR, Khaw K, Hopwood BE, Mugambi M, Peart WS, Sever PS. Determinants of blood pressure changes due to urbanization: A longitudinal study. J Hypertens 1985; 3: S375–S377

    CAS  Google Scholar 

  17. Blacher J, Asmar R, Djane S, London GM, Safar ME. Aortic pulse wave velocity as a marker of cardiovascular risk in hypertensive patients. Hypertension 1999; 33: 1111–1117

    PubMed  CAS  Google Scholar 

  18. Nurnberger J, Dammer S, Opazo-Saez A, Philipp T, Schafers RF. Diastolic blood pressure is an important determinant of augmentation index and pulse wave velocity in young healthy males. J Hum Hypertens 2003; 17: 153–158

    Article  PubMed  CAS  Google Scholar 

  19. Wilkinson IB, Mohammad NH, Tyrrell S, Hall IR, Webb DJ, Paul VE, Levy T, Cockcroft JR. Heart rate dependency of pulse pressure amplification and arterial stiffness. Am J Hypertens 2002; 15: 24–30

    Article  PubMed  Google Scholar 

  20. Cavalcanti S. Arterial Baroreflex influence on heart rate variability: A mathematical model-based analysis. Med Biol Eng Comput 2000; 38: 189–197

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Jong Yong A. Foo PhD.

Additional information

Foo JYA, Wilson SJ, Wang P. Factors that affect pulse wave time transmission in the monitoring of cardiovascular system.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Foo, J.Y.A., Wilson, S.J. & Wang, P. Factors that Affect Pulse Wave Time Transmission in the Monitoring of Cardiovascular System. J Clin Monit Comput 22, 141–147 (2008). https://doi.org/10.1007/s10877-008-9115-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10877-008-9115-2

Keywords

Navigation