Differential response of peripheral arterial compliance-related indices to a vasoconstrictive stimulus

Noninvasive Characterization of Vascular Tone by Model-Based System Identification in Healthy and Heart Failure Patients

Current markers for heart failure (HF) diagnosis and prognosis are mainly for the evaluation of cardiac functions. Since previous studies have reported that HF patients demonstrated abnormal vascular responses to external stimuli, it is speculated that vascular tone, a measure of activation level of vascular wall, may be able to reflect these abnormalities to assist HF detection. Nevertheless, vascular tone is difficult to be objectively quantified using existing tools. In this study, a vascular tone index was estimated from noninvasive blood pressure and pulse transit time measurements using system identification technique. This method was evaluated in 35 subjects (10 healthy, 13 with HF risk factors and 12 HF patients) in a regular maximal exercise test. It was found that the vascular tone index significantly increased by 24.4 ± 26.6% (p < 0.01) during maximal exercise in the healthy subjects. Moreover, the response was gradually attenuated in the risk-factor and HF groups (15.8 ± 36.5 and 0.9 ± 17.9%, respectively). The results reveal the association between the vascular tone response to maximal exercise and HF disease or risks. To conclude, the proposed method provides a quantitative characterization of vascular tone which may be a useful indicator of the pathological changes of the arteries or the heart.

A novel photoplethysmography technique to derive normalized arterial stiffness as a blood pressure independent measure in the finger vascular bed

Stiffening of the small artery may be the earliest sign of arteriosclerosis. However, there is no adequate method for directly assessing small arterial stiffness. In this study, the finger arterial elasticity index (FEI) was defined as the parameter n which denotes the curvilinearity of an exponential model of pressure (P)-volume (V(a)) relationship (V(a) = a - b exp (-nP)). For the original estimation, the FEI was calculated from a compliance index from the finger photoplethysmogram whilst occluding the finger. A simple estimation of the FEI was devised by utilizing normalized pulse volume instead of the compliance index. Both estimations yielded close agreement with the exponential model in healthy young participants (study 1: n = 19). Since the FEI was dependent on finger mean blood pressure, normalized finger arterial stiffness index (FSI) was defined as standardized residual from their relationship: mean and standard deviation (SD) of the FSI were 50 ± 10 (study 2: n = 174). The mean coefficient of variation of the FSI for four measurements was 5.72% (study 3: n = 6). The mean and SD of the FSI in seven arteriosclerotic patients were 100.0 ± 13.5. In conclusion, the FEI and FSI by simple estimation are valid and useful for arteriosclerosis research.