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Pulse transit time as a derived noninvasive mean to monitor arterial distensibility changes in children

Journal of Human Hypertension volume 19, pages 723–729 (2005)Cite this article

Abstract

Changes in arterial distensibility have been widely used to identify the presence of cardiovascular abnormalities like hypertension. Pulse wave velocity (PWV) has shown to be related to arterial distensibility. However, the lack of suitable techniques to measure PWV nonintrusively has impeded its clinical usefulness. Pulse transit time (PTT) is a noninvasive technique derived from the principle of PWV. PTT has shown its capabilities in cardiovascular and cardiorespiratory studies in adults. However, no known study has been conducted to understand the suitability and utility of PTT to estimate PWV in children. Two computational methods to derive PWV from PTT values obtained from 23 normotensive Caucasian children (19 males, aged 5–12 years old) from their finger and toe were conducted. Furthermore, the effects of adopting different postures on the PWV derivations were investigated. Statistical analyses were performed in comparison with two previous PWV studies conducted on children. Results revealed that PWV derived from the upper limb correlated significantly (P<0.05) regardless of computing methods or postures adopted. The findings here suggest that PTT measurement can be used as a convenient and noninvasive surrogate measure of derived PWV in prolonged clinical studies, especially on younger or less cooperative children. Furthermore, the simple set-up and noninvasive nature of PTT can promote its usefulness in ambulatory monitoring.

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References

  1. Avolio AP et al. Effects of aging on changing arterial compliance and left ventricular load in a northern Chinese urban community. Circulation 1983; 68: 50–58.

    Article  CAS  Google Scholar 

  2. Cheung YF et al. Arterial distensibility in children and teenagers: Normal evolution and the effect of childhood vasculitis. Arch Dis Child 2002; 87: 348–351.

    Article  CAS  Google Scholar 

  3. Senzaki H et al. Age-associated changes in arterial elastic properties in children. Eur J Pediatr 2002; 161: 547–551.

    Article  Google Scholar 

  4. Martin H, Hu J, Gennser G, Norman M . Impaired endothelial function and increased carotid stiffness in 9-year-old children with low birthweight. Circulation 2000; 102: 2739–2744.

    Article  CAS  Google Scholar 

  5. Lurbe J et al. Birth weight impacts on wave reflections in children and adolescents. Hypertension 2003; 41 (Part 2): 646–650.

    Article  CAS  Google Scholar 

  6. Nolly H et al. Home blood pressure measurement: validation of the Braun BP 2550 (UG) monitor according to the ESH International Protocol. Blood Press Monit 2004; 9: 53–58.

    Article  Google Scholar 

  7. Ng KG et al. Progress on the development of the MediWatch ambulatory blood pressure monitor and related devices. Blood Press Monit 2004; 9: 149–165.

    Article  Google Scholar 

  8. Brands PJ et al. A noninvasive method to estimate pulse wave velocity in arteries locally by means of ultrasound. Ultrasound Med Biol 1998; 24: 1325–1335.

    Article  CAS  Google Scholar 

  9. Wang YYL et al. Pressure pulse velocity is related to the longitudinal elastic properties of the artery. Physiol Meas 2004; 25: 1397–1403.

    Article  Google Scholar 

  10. Smith RP, Argod J, Pepin JL, Levy PA . Pulse transit time: an appraisal of potential clinical applications. Thorax 1999; 54: 452–458.

    Article  CAS  Google Scholar 

  11. Pitson D, Chhina N, Knijn S . Changes in pulse transit time and pulse rate as markers of arousal from sleep in normal subjects. Clin Sci 1994; 87: 269–273.

    Article  CAS  Google Scholar 

  12. Katz ES, Lutz J, Black C, Marcus CL . Pulse transit time as a measure of arousal and respiratory effort in children with sleep-disordered breathing. Pediatr Res 2003; 53: 580–588.

    Article  Google Scholar 

  13. Argod J, Pepin JL, Smith RP, Levy P . Comparison of esophageal pressure with pulse transit time as a measure of respiratory effort for scoring obstructive nonapneic respiratory events. Am J Respir Crit Care Med 2000; 162: 87–93.

    Article  CAS  Google Scholar 

  14. 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  CAS  Google Scholar 

  15. 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  CAS  Google Scholar 

  16. Pickering TG . Principles and techniques of blood pressure measurement. Cardiol Clin 2002; 20: 207–223.

    Article  Google Scholar 

  17. Behrman RE, Kliegman RM, Jenson HB . Nelson Textbook of Pediatrics 2004, 17th edn. WB Saunders Company: Philadelphia, pp 1484–1488.

    Google Scholar 

  18. National high blood pressure education program working group on high blood pressure in children and adolescents. The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Pediatrics 2004; 114: 555–576.

  19. Marieb EN . Human Anatomy and Physiology 2004, 6th edn. Pearson Benjamin Cummings: San Francisco, pp 688–698.

    Google Scholar 

  20. Okada M, Kimura S, Okada M . Estimation of arterial pulse wave velocities in the frequency domain: method and clinical considerations. Med Biol Eng Comput 1986; 24: 255–260.

    Article  CAS  Google Scholar 

  21. 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  CAS  Google Scholar 

  22. Mitchell GF et al. Changes in arterial stiffness and wave reflection with advancing age in healthy men and women. The Framingham Heart study. Hypertension 2004; 43: 1239–1245.

    Article  CAS  Google Scholar 

  23. Rabben SI et al. An ultrasound-based method for determining pulse wave velocity in superficial arteries. J Biomech 2004; 37: 1615–1622.

    Article  Google Scholar 

  24. Pawelczyk JA, Levine BD . Heterogeneous responses of human limbs to infused adrenergic agonists: a gravitational effect. J Appl Physiol 2002; 92: 2105–2113.

    Article  CAS  Google Scholar 

  25. Frey MA, Tomaselli CM, Hoffler WG . Cardiovascular responses to postural changes: Differences with age for women and men. J Clin Pharmacol 1994; 34: 394–402.

    Article  CAS  Google Scholar 

  26. Ip MSM et al. Lung function reference values in Chinese children and adolescents in Hong Kong II. Prediction equations for plethysmographic lung volumes. Am J Respir Crit Care Med 2000; 162: 430–435.

    Article  CAS  Google Scholar 

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Authors and Affiliations

  1. School of Information Technology and Electrical Engineering, University of Queensland, St Lucia Campus, Brisbane, Queensland, Australia

    J Y A Foo & S J Wilson

  2. Department of Respiratory and Sleep Medicine, Mater Children's Hospital, South Brisbane, Queensland, Australia

    G Williams, M-A Harris & D Cooper

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  1. J Y A Foo
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  2. S J Wilson
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  3. G Williams
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  4. M-A Harris
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  5. D Cooper
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Correspondence to J Y A Foo.

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Foo, J., Wilson, S., Williams, G. et al. Pulse transit time as a derived noninvasive mean to monitor arterial distensibility changes in children. J Hum Hypertens 19, 723–729 (2005). https://doi.org/10.1038/sj.jhh.1001891

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