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  • Characterisation of the aortic pulse profile of a radial artery applanation tonometry device in patients with aortic stenosis

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Medical devices
Original article
Characterisation of the aortic pulse profile of a radial artery applanation tonometry device in patients with aortic stenosis
  1. Nicholas Ngiam1,
  2. Xiayan Shen1,
  3. Benjamin Yong-Qiang Tan1,
  4. Sachiko Oinuma2,
  5. Glenn KM Lee1,
  6. William KF Kong3,
  7. Kian-Keong Poh3,4
  1. 1 University Medicine Cluster, National University Health System, Singapore
  2. 2 Department of Home Medical Care, Tokyo Women’s Medical University Medical Center East, Tokyo, Japan
  3. 3 Department of Cardiology, National University Heart Centre, National University Health System, Singapore
  4. 4 Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
  1. Correspondence to Dr Nicholas Ngiam, University Medicine Cluster, National University Health System, Singapore 119228; nicholas_ngiam{at}nuhs.edu.sg

Abstract

Background Aortic stenosis (AS) is commonly associated with myocardial and systemic arterial dysfunction. We use a radial artery applanation tonometry (B-Pro) device to characterise the arterial pulse profile of patients with AS and compare them against controls.

Methods The B-Pro device was applied on the left radial artery of 117 consecutive patients, where 21 patients had AS. Baseline clinical and echocardiographic characteristics were compared. Differences in arterial pulse pressure profile were quantified by means of univariate and multivariable analyses.

Results The group with AS was older (74±14 vs 62±14 years, P<0.001) and had fewer males (38% vs 65%, P=0.025), while other baseline comorbidities were similar. From the arterial pulse profile, a higher systolic peak time (202±45 vs 152±49 ms, P<0.001), lower systolic upstroke gradient (0.35±0.10 vs 0.42±0.14 mm Hg/ms, P=0.022) and longer systolic component of the cardiac cycle (43%±7% vs 39%±5%, P=0.001) were independently associated with AS.

Conclusion The B-Pro device allows for real-time microscopic arterial pulse waveform analysis. There are significant differences between the pulse profiles of patients with AS and controls. The prognostic implications of these differences warrant further study.

  • aortic stenosis
  • radial applanation tonometry
  • pulse wave reflection

https://doi.org/10.1136/bmjinnov-2017-000210

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    Footnotes

    • Contributors NN was involved in the data analysis and conception, writing of the manuscript and submitted the manuscript. XS was involved in the data analysis and conception and writing of the manuscript. Y-QBT was involved in the conception and writing of the manuscript. SO was involved in the data collection and analysis. GKML was involved in data analysis. WKFK was involved in the writing of the manuscript. K-KP was involved in the conception and writing of the manuscript.

    • Funding There was no monetary funding for this study.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Ethics approval The study was approved by the National Healthcare Group Institutional Review Board, Singapore.

    • Provenance and peer review Not commissioned; externally peer reviewed.