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Comparison of noninvasive pulse transit time determined from Doppler aortic flow and multichannel bioimpedance plethysmography


The main goal of this study was to make a comparison of aortic flow timing obtained by PW Doppler in four aortic sections with timing of − dZ/dt max obtained by bioimpedance measurement in nine locations on the thorax and neck. This knowledge is essential for determination of which bioimpedance channel could be used as a proximal for evaluation of pulse wave velocity (PWV) from the beginning of the ascending aorta or another aortic section. Time intervals between the Doppler flow and bioimpedance information (− dZ/dt max) were compared. It was found that the channel located on the left part of the neck is the most suitable as a proximal bioimpedance channel which corresponds to the aortic arch. This match is obtained with regard to the value of the time difference as well as inter-subject stability. This channel can be used as a proximal for evaluation of pulse wave velocity from the aortic arch to the desired distal target place in the body when distance between measured parts is known. The data from 35 volunteers with adequate signal quality were analyzed.

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  1. Asmar R, Rudnichi A, Blacher J, etal (2001) Pulse pressure and aortic pulse wave are markers of cardiovascular risk in hypertensive population. Am J Hypertens 14:91–97

  2. Koivistoinen T, Kööbi T, Jula a, et al (2007) Pulse wave velocity reference values in healthy adults aged 26-75 years. Clin Physiol Funct imaging 27:191–196 . doi:

  3. Lehmann ED (1999) Clinical value of aortic pulse-wave velocity measurement. Lancet 354:528–529.

    Article  CAS  PubMed  Google Scholar 

  4. Kööbi T, Kähönen M, Iivainen T, Turjanmaa V (2003) Simultaneous non-invasive assessment of arterial stiffness and haemodynamics—a validation study. Clin Physiol Funct Imaging 23:31–36.

    Article  PubMed  Google Scholar 

  5. Mitchell GF (2009) Clinical achievements of impedance analysis. Med Biol Eng Comput 47:153–163.

    Article  PubMed  Google Scholar 

  6. Lee D-H, Youn H-J, Chung W-B, Choi YS, Lee JM, Park CS, Jung HO, Jeon HK, Lee MY (2017) Effects of metabolic syndrome on aortic pulse wave velocity. Clin Hypertens 23(1):1.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Sugawara M, Niki K, Ohte N, Okada T, Harada A (2009) Clinical usefulness of wave intensity analysis. Med Biol Eng Comput 47:197–206.

    Article  PubMed  Google Scholar 

  8. Salvi P, Lio G, Labat C, Ricci E, Pannier B, Benetos A (2004) Validation of a new non-invasive portable tonometer for determining arterial pressure wave and pulse wave velocity: the PulsePen device. J Hypertens 22:2285–2293

    Article  CAS  PubMed  Google Scholar 

  9. Jiang B, Liu B, McNeill KL, Chowienczyk PJ (2008) Measurement of pulse wave velocity using pulse wave Doppler ultrasound: comparison with arterial tonometry. Ultrasound Med Biol 34:509–512.

    Article  PubMed  Google Scholar 

  10. Wassertheurer S, Kropf J, Weber T, van der Giet M, Baulmann J, Ammer M, Hametner B, Mayer CC, Eber B, Magometschnigg D (2010) A new oscillometric method for pulse wave analysis: comparison with a common tonometric method. J Hum Hypertens 24:498–504.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Asmar R (1999) Arterial stiffness and pulse wave velocity: clinical applications. Elsevier, Amsterdam ; Oxford

  12. Baguet J-P, Kingwell BA, Dart AL et al (2003) Analysis of the regional pulse wave velocity by Doppler: methodology and reproducibility. J Hum Hypertens 17:407–412.

    Article  PubMed  Google Scholar 

  13. Matejkova M, Vondra V, Halamek J, et al Measurement of pulse wave velocity during valsalva and mueller maneuvers by whole body impedance monitor. 1117–1120

  14. Soukup L, Vondra V, Viscor I, Jurak P, Halamek J (2013) Effect of pacing rate on cardiac output and pulse wave velocity at rest. J Electrocardiol 46:e11.

    Article  Google Scholar 

  15. Soukup L, Vondra V, Viscor I, et al (2013) Pulse wave velocity and cardiac output vs. heart rate in patients with an implanted pacemaker based on electric impedance method measurement. Xv Int Conf Electr Bio-Impedance Xiv Conf Electr Impedance Tomogr 434:7–11 . doi: Unsp 012050\rDoi

  16. Vondra V, Jurak P, Viscor I, Halamek J, Leinveber P, Matejkova M, Soukup L (2016) A multichannel bioimpedance monitor for full-body blood flow monitoring. Biomed Tech (Berl) 61:107–118.

    Article  Google Scholar 

  17. Bernstein DP, Lemmens HJM (2005) Stroke volume equation for impedance cardiography. Med Biol Eng Comput 43:443–450.

    Article  CAS  PubMed  Google Scholar 

  18. Vondra V, Jurak P, Halamek J, Viscor I (2008) Device for blood flow property measurement and method of its connection. Pat Appl Publ 1

  19. Kubicek WG, Patterson RP, Witsoe DA (1970) Impedance cardiography as a noninvasive method of monitoring cardiac function and other parameters of the cardiovascular system. Ann N Y Acad Sci 170:724–732.

    Article  Google Scholar 

  20. Kubicek WG, Karnegis JN, Patterson RP, Witsoe DA, Mattson RH (1966) Development and evaluation of an impedance cardiac output system. Aerosp Med 37:1208–1212

    CAS  PubMed  Google Scholar 

  21. Baura GD (2002) System theory and practical applications of biomedical signals. IEEE Press

  22. Bernstein DP (2010) Impedance cardiography: pulsatile blood flow and the biophysical and electrodynamic basis for the stroke volume equations. J Electr Bioimpedance 1:2.

    Article  Google Scholar 

  23. Korkmaz L, Erkan H, Korkmaz AA et al (2012) Relationship of aortic knob width with cardio-ankle vascular stiffness index and its value in diagnosis of subclinical atherosclerosis in hypertensive patients: a study on diagnostic accuracy. Anadolu Kardiyol Derg 12:102–106.

    Article  PubMed  Google Scholar 

  24. Saji N, Kimura K, Shimizu H, Kita Y (2012) Silent brain infarct is independently associated with arterial stiffness indicated by cardio-ankle vascular index (CAVI). Hypertens Res 35:756–760.

    Article  PubMed  Google Scholar 

  25. Yamashina A, Tomiyama H, Takeda K et al (2002) Validity, reproducibility, and clinical significance of noninvasive brachial-ankle pulse wave velocity measurement. Hypertens Res 25:359–364.

    Article  PubMed  Google Scholar 

  26. Shirai K, Hiruta N, Song M, Kurosu T, Suzuki J, Tomaru T, Miyashita Y, Saiki A, Takahashi M, Suzuki K, Takata M (2011) Cardio-ankle vascular index (CAVI) as a novel indicator of arterial stiffness: theory, evidence and perspectives. J Atheroscler Thromb 18:924–938.

    Article  PubMed  Google Scholar 

  27. Wentland AL, Grist TM, Wieben O (2014) Review of MRI-based measurements of pulse wave velocity: a biomarker of arterial stiffness. Cardiovasc Diag Ther 4:193–206.

    Article  Google Scholar 

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This study was supported by project no. LQ1605 from National Program of Sustainability II (MEYS CR) and MUNI/A/1157/2017.

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Correspondence to Ladislav Soukup.

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The study was approved by the ethics committee at St. Anne’s University Hospital Brno. Informed consent was obtained from all individual participants included in the study.

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The authors declare that they have no conflict of interest.

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Soukup, L., Hruskova, J., Jurak, P. et al. Comparison of noninvasive pulse transit time determined from Doppler aortic flow and multichannel bioimpedance plethysmography. Med Biol Eng Comput 57, 1151–1158 (2019).

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  • Bioimpedance
  • Doppler ultrasound
  • Pulse wave velocity (PWV)
  • Pulse transit time (PTT)