The vascular impact of aging and vasoactive drugs: comparison of two digital volume pulse measurements.

BACKGROUND Indices of pressure wave reflection (RI(DVP)) and large artery stiffness (SI(DVP)) can be derived from the digital volume pulse (DVP). Indices obtained from the second derivative of the DVP have also been proposed to characterize vascular aging and effects of vasoactive drugs. METHODS We compared RI(DVP) and SI(DVP) with the indices a/b, a/c, a/d, and a/e calculated from sequential peaks of the second derivative of the DVP in 124 healthy men. The DVP was obtained by measuring infrared light transmission through the finger. In 10 men measurements were obtained at baseline and during intravenous infusion of glyceryl trinitrate (GTN, 3 to 300 microg/min) and, on separate occasions, angiotensin II (AII, 75 to 300 microg/min) and saline vehicle. RESULTS SI(DVP) was strongly associated with age (R = 0.63, P <.001) but little influenced by AII or GTN. RI(DVP) was weakly associated with age but showed a consistent dose-dependent increase during AII and a decrease during GTN. d/a was strongly associated with age (R = -0.66, P <.001), influenced by vasoactive drugs but did not change in a dose-dependent manner during GTN. Other second derivative indices were less strongly correlated with age and showed an inconsistent response to vasoactive drugs. Within subject standard deviations of SI(DVP) and d/a for measurements on different occasions were 2.1 and 5.4 "years of vascular aging" respectively. CONCLUSIONS In healthy men, RI(DVP) may be a more reliable index of the effects of vasoactive drugs than d/a. SI(DVP) is similarly associated with age as is d/a, but less variable and may thus be a better index of vascular aging.

[1]  M. E. Safar,et al.  Aortic Pulse Wave Velocity Predicts Cardiovascular Mortality in Subjects >70 Years of Age , 2001, Arteriosclerosis, thrombosis, and vascular biology.

[2]  R. Gosling,et al.  Photoplethysmographic assessment of pulse wave reflection: blunted response to endothelium-dependent beta2-adrenergic vasodilation in type II diabetes mellitus. , 1999, Journal of the American College of Cardiology.

[3]  J. Blacher,et al.  Aortic pulse wave velocity as a marker of cardiovascular risk in hypertensive patients. , 1999, Hypertension.

[4]  A P Avolio,et al.  Nitroglycerin has more favourable effects on left ventricular afterload than apparent from measurement of pressure in a peripheral artery. , 1990, European heart journal.

[5]  K. Takazawa,et al.  Assessment of vascular aging and atherosclerosis in hypertensive subjects: second derivative of photoplethysmogram versus pulse wave velocity. , 2000, American journal of hypertension.

[6]  T. Andersson,et al.  Vitamin E restores endothelium dependent vasodilatation in cholesterol fed rabbits: in vivo measurements by photoplethysmography. , 1994, Cardiovascular research.

[7]  K. Takazawa,et al.  Assessment of vasoactive agents and vascular aging by the second derivative of photoplethysmogram waveform. , 1998, Hypertension.

[8]  YUKIO MORIKAWA,et al.  Characteristic Pulse Wave caused by Organic Nitrates , 1967, Nature.

[9]  John B. Dillon,et al.  The form of the volume pulse in the finger pad in health, arteriosclerosis, and hypertension , 1941 .

[10]  W. Nichols,et al.  McDonald's Blood Flow in Arteries: Theoretical, Experimental and Clinical Principles , 1998 .

[11]  P. Chowienczyk,et al.  Noninvasive Assessment of the Digital Volume Pulse: Comparison With the Peripheral Pressure Pulse , 2000, Hypertension.

[12]  H Quan,et al.  Assessing reproducibility by the within-subject coefficient of variation with random effects models. , 1996, Biometrics.

[13]  Ikuharu Morioka,et al.  Noninvasive assessment of arterial distensibility in adolescents using the second derivative of photoplethysmogram waveform , 2001, European Journal of Applied Physiology.

[14]  F. Lund.  Digital pulse plethysmography (DPG) in studies of the hemodynamic response to nitrates--a survey of recording methods and principles of analysis. , 2009, Acta pharmacologica et toxicologica.

[15]  M. O'Rourke,et al.  Quantification of glyceryl trinitrate effect through analysis of the synthesised ascending aortic pressure waveform , 2002, Heart.

[16]  T. Ohkubo,et al.  Pulse wave velocity and the second derivative of the finger photoplethysmogram in treated hypertensive patients: their relationship and associating factors , 2002, Journal of hypertension.

[17]  P. Ducimetiere,et al.  Aortic Stiffness Is an Independent Predictor of All-Cause and Cardiovascular Mortality in Hypertensive Patients , 2001, Hypertension.

[18]  R H Fagard,et al.  Effect of age on brachial artery wall properties differs from the aorta and is gender dependent: a population study. , 2000, Hypertension.