Attenuation of Systolic Blood Pressure and Pulse Transit Time Hysteresis During Exercise and Recovery in Cardiovascular Patients
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摘要Pulse transit time (PTT) is a cardiovascular parameter of emerging interest due to its potential to estimate blood pressure (BP) continuously and without a cuff. Both linear and nonlinear equations have been used in the estimation of BP based on PTT. This study, however, demonstrates that there is a hysteresis phenomenon between BP and PTT during and after dynamic exercise. A total of 46 subjects including 16 healthy subjects, 13 subjects with one or more cardiovascular risk factors, and 17 patients with cardiovascular disease underwent graded exercise stress test. PTT was measured from electrocardiogram and photoplethysmogram of the left index finger of the subject, i.e., a pathway that includes predominately aorta, brachial, and radial arteries. The results of this study showed that, for the same systolic BP (SBP), PTT measured during exercise was significantly larger than PTT measured during recovery for all subject groups. This hysteresis was further quantified as both normalized area bounded by the SBP-PTT relationship (AreaN) and SBP difference at PTT during peak exercise plus 20 ms (Delta SBP20). Significant attenuation of both AreaN (p < 0.05) and Delta SBP20 (p < 0.01) is observed in cardiovascular patients compared with healthy subjects, independent of resting BP. Since the SBP-PTT relationship are determined by the mechanical properties of arterial wall, which is predominately mediated by the sympathetic nervous system through altered vascular smooth muscle (VSM) tone during exercise, results of this study are consistent with the previous findings of autonomic nervous dysfunction in cardiovascular patients. We further conclude that VSM tone has a nonnegligible influence on the BP-PTT relationship and thus should be considered in the PTT-based BP estimation.
著者Liu Q, Yan BP, Yu CM, Zhang YT, Poon CCY
期刊名稱IEEE Transactions on Biomedical Engineering
出版年份2014
月份2
日期1
卷號61
期次2
出版社IEEE-INST ELECTRICAL ELECTRONICS ENGINEERS INC
頁次346 - 352
國際標準期刊號0018-9294
電子國際標準期刊號1558-2531
語言英式英語
關鍵詞Cuffless blood pressure (BP); mobile health; pulse transit time (PTT); vascular smooth muscle (VSM) tone; wearable device
Web of Science 學科類別Engineering; Engineering, Biomedical; ENGINEERING, BIOMEDICAL

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