Analysis of Arterial Stiffness by Age Using Pulse Waveform Measurement of 5-levels Graded Pressure

5단계 가압 맥파측정에 의한 연령별 혈관 경화도 분석

  • Kwon, Sun-Min (Dept. of Biomedical Engineering, College of Health Science, Yonsei University) ;
  • Kang, Hee-Jung (Daeyomedi Co., Ltd.) ;
  • Yim, Yun-Kyoung (Dept. of Meridian & Acupoint, College of Oriental Medicine, Daejeon University) ;
  • Lee, Yong-Heum (Dept. of Biomedical Engineering, College of Health Science, Yonsei University)
  • 권선민 (연세대학교 보건과학대학 의공학과 한의공학연구실) ;
  • 강희정 (대요메디(주)) ;
  • 임윤경 (대전대학교 한의과대학 경락경혈학교실) ;
  • 이용흠 (연세대학교 보건과학대학 의공학과 한의공학연구실)
  • Received : 2010.05.22
  • Accepted : 2010.06.11
  • Published : 2010.06.27

Abstract

Objectives : The aim of this study is to measure pulse waveforms by applying 5-level graded pressure, and selecting optimum pulse waveforms. Also to proposing the possibility of using AW(Area of the 1/3 upper height of h1) rate in respect to AT(Total Area) for risk assessment of hypertension or arteriosclerosis is another aim of the study. Methods : Pulse waveforms of normotensive were measured by 5-level graded pressure. The pulse waveforms well reflecting properties of blood vessel(having the largest h1) were selected for optimum pulse waveforms. Various parameters(h-parameter, t-parameter, and others) of optimum pulse waveforms were analyzed. AIx(Augmentation index) was calculated by height-parameters to assess arterial stiffness. The area rate of the 1/3 upper height for h1 in respect to total area was analyzed according to aging. Results : According to aging 1. in height-parameter, h2 and h3 were increased but h5 was decreased. 2. In time-parameter, t2, t3, and t5 were getting short. 3. Area of systolic period was increased, and that of diastolic period decreased. 4. AIx rose by aging. 5. AW was significantly increased despite no changes in AT. Conclusions : By analyzing optimum pulse waveforms of 5-level graded pressure method, we could complement weakness of single graded pressure method. Also, possibility of applying the AW rate to risk assessment of hypertension or arteriosclerosis was confirmed in normotensive population which might not be assessed by AIx.

Keywords

References

  1. 정봉교, 김지연. 스트레스 취약성 및 과제가 심혈관계 반응성에 미치는 영향. 한국심리학회지 건강. 2004 ; 9(4) : 935-52.
  2. 조진만, 김종진, 신우승, 조은주, 박철수, 김범준, 외. 관상동맥 질환으로 입원한 한국인 환자의 임상양상과 예후인자. 대한내과학회지. 2007 ; 73(2) : 142-50.
  3. Hirofumi Tomiyama, Mutsuo Yamazaki, Yasuhiro Sagawa, Kunihiko Teraoka, Tsunemichi Shirota, Yoshinori Miyawaki, et al. Synergistic effect of smoking and blood pressure on augmentation index in men, but not in women. Hypertension Research. 2009 ; 32(2) : 122-6. https://doi.org/10.1038/hr.2008.20
  4. Azra Mahmud, John Feely. Acute Effect of Caffeine on Arterial Stiffness and Aortic Pressure Waveform. Hypertension. 2001 ; 38(2) : 227-31. https://doi.org/10.1161/01.HYP.38.2.227
  5. Charalambos Vlachopoulous, Nikolaos Alexopoulos, Demosthenes Panagiotakos, Michael F. O'Rourke, Christodoulos Stefanadis. Cigar Smoking Has an Acute Detrimental Effect on Arterial Stiffness. Am. J. Hypertension. 2004 ; 17 : 299-303. https://doi.org/10.1016/j.amjhyper.2003.12.014
  6. Marijke J. C. A. van Trijp, Joline W. J. Beulens, Willem J. W. Bos, Cuno S. P. M. Uiterwaal, Diederick E. Grobbee, Jenk F. J. Hendriks, et al. Alcohol Consumption and Augmentation Index in Healthy Young Men: The ARYA Study. Am. J. Hypertension. 2005 ; 18 : 792-6. https://doi.org/10.1016/j.amjhyper.2004.12.011
  7. Kozo Hirata, Toshio Yaginuma, Michael F. O'Rourke, Masanobu Kawakami. Agerelated Changes in Carotid Artery Flow and Pressure Pulses: Possible Implications for Cerebral Microvascular Disease. Stroke. 2006 ; 37(10) : 2552-6. https://doi.org/10.1161/01.STR.0000242289.20381.f4
  8. Giuseppe Schillaci, Massimo R. Mannarino, Giacomo Pucci, Matteo Pirro, Johny Helou, Gianluca Savarese, et al. Age-Specific Relationship of Aortic Pulse Wave Velocity With Left Ventricular Geometry and Function in Hypertension. Hypertension. 2007 ; 49(2) : 317-21.
  9. Kenji Takazawa. Augmentation Index in Heart Disease. Am. J. Hypertension. 2005 ; 18 : 15s-8s.
  10. 김경철, 강희정. 맥(脈) 의공학 연구방법론. 안산 : 대요메디(주). 2008 : 499.
  11. 조영일, 유정열, 서상호, 이병권, 이상준, 권혁문. 생체유체역학(BIO FLUID MECHANICS). 서울 : 야스미디어. 2006 : 479.
  12. Wilmer W. Nichols. Clinical Measurement of Arterial Stiffness Obtained From Noninvasive Pressure Waveforms. Am. J. Hypertension. 2005 : 3s-10s
  13. Junichiro Hashimoto, Sadayoshi Ito. Some mechanical aspects of arterial aging: physiological overview based on pulse wave analysis. Therapeutic Advances in Cardiovascular Disease. 2009 ; 3(5) : 367-78. https://doi.org/10.1177/1753944709338942
  14. Michael F. O'Rourke, Wilmer W. Nichols. Aortic Diameter, Aortic Stiffness, and Wave Reflection Increase With Age Isolated Systolic Hypertension. Hypertension. 2005 ; 45(4) : 652-8. https://doi.org/10.1161/01.HYP.0000153793.84859.b8
  15. Kelly R, Hayward C, Avolio A, O'Rourke MF. Noninvasive determination of agerelated changes in the human arterial pulse. Circulation. 1989 ; 80 : 1652-9. https://doi.org/10.1161/01.CIR.80.6.1652
  16. Gary F. Mitchell, Helen Parise, Emelia J. Benjamin, Martin G. Larson, Michelle J. Keyes, Joseph A. Vita, et al. Changes in Arterial Stiffness and Wave Reflection With Advancing Age in Healthy Men and Women: The Framingham Heart Study. Hypertension. 2004 ; 43(6) : 1239-45. https://doi.org/10.1161/01.HYP.0000128420.01881.aa
  17. Gary E. McVeigh, Christopher W. Bratteli, Dennis J. Morgan, Cheryl M. Alinder, Stephen P. Glasser, Stanley M. Finkelstein, et al. Age-related Abnormalities in Arterial Compliance Identified by Pressure Pulse Contour Analysis : Aging and Arterial Compliance. Hypertension. 1999 ; 33(6) : 1392-8. https://doi.org/10.1161/01.HYP.33.6.1392
  18. T. Koivistoinen, T. Koobi, A. Jula, N. Hutri-Kahonen, O. T. Raitakari, S. Majahalme, et al. Pulse wave velocity reference values in healthy adults aged 26-75 years. clin. Physiol. Funct. Imaging. 2007 ; 27(3) : 191-6. https://doi.org/10.1111/j.1475-097X.2007.00734.x
  19. Carmel M. McEniery, Yasmin, Ian R. Hall, Ahmad Qasem, Ian B. Wilkinson, John R. Cockcroft, et al. Normal Vascular Aging: Differential Effects on Wave Reflection and Aortic Pulse Wave Velocity. Journal of the American College of Cardiology. 2005 ; 46(9) : 1753-60. https://doi.org/10.1016/j.jacc.2005.07.037
  20. Merrill F. Elias, Michael A. Robbins, Marc M. Budge, Walter P. Abhayaratna, Gregory A. Dore, Penelope K. Elias. Arterial Pulse Wave Velocity and Cognition With Advancing Age. Hypertension. 2009 ; 53(4) : 668-73. https://doi.org/10.1161/HYPERTENSIONAHA.108.126342
  21. Walter J. Rogers, Yong-Lin Hu, Douglas Coast, Diane A. Vido, Christopher M. Kramer, Reed E. Pyeritz, et al. Age-Associated Changes in Regional Aortic Pulse Wave Velocity. J. Am. Coll. Cardiol. 2001 ; 38(4) : 1123-9. https://doi.org/10.1016/S0735-1097(01)01504-2
  22. Katsuhiko Kohara, Yasuharu Tabara, Akira Oshiumi, Yoshinori Miyawaki, Tatsuya Kobayashi, Tetsuro Miki. Radial Augmentation Index: A Useful and Easily Obtainable Parameter for Vascular Aging. Am. J. Hypertension. 2005 ; 18 : 11s-4s.
  23. Francesco Fantin, Adriana Mattocks, Christopher J. Bulpitt, Winston Banya, Chakravarthi Rajkumar. Is augmentation index a good measure of vascular stiffness in the elderly?. Age and Ageing. 2007 ; 36(1) : 43-8.
  24. 권선민, 강희정, 이상훈, 임윤경, 이용흠. 측정 자세의 변화에 따른 맥의 변화 특성: 선 자세, 앉은 자세, 누운 자세. 경락경혈학회지. 2009 ; 26(4) : 13-22.
  25. 권선민, 강희정, 임윤경, 이용흠. 5단계 가압에 대한 맥파 변화 분석에 의한 맥패턴 분류와 부침맥(浮沈脈) 연구. 경락경혈학회지. 2010 ; 27(1) : 13-22.