Novel Peripheral Perfusion Dynamics Indices for Detecting and Grading Arterial Stenosis.
Ankle-brachial index
Arterial stenosis
Arteriosclerosis
Perfusion dynamics
Peripheral artery disease
Journal
Cardiovascular engineering and technology
ISSN: 1869-4098
Titre abrégé: Cardiovasc Eng Technol
Pays: United States
ID NLM: 101531846
Informations de publication
Date de publication:
12 2023
12 2023
Historique:
received:
09
08
2021
accepted:
11
09
2023
medline:
22
12
2023
pubmed:
21
11
2023
entrez:
20
11
2023
Statut:
ppublish
Résumé
Peripheral artery disease causes severe morbidity, especially in diabetics and the elderly. There is a need for accurate noninvasive detection of peripheral arterial stenosis. The study has tested the hypothesis that arterial stenosis and the associated adaptation of the downstream circulation yield characteristic changes in the leg perfusion dynamics that enable early diagnosis, utilizing impedance plethysmography. The arterial perfusion dynamic was derived from impedance plethysmography (IPG). Two degrees of arterial stenosis were emulated by inflating a blood-pressure cuff around the thigh to 45 and 90 mmHg, in healthy volunteers (n = 30). IPG signals were acquired continuously throughout the experiment. Ankle and brachial blood pressures were measured at the beginning of each experiment and at the end of each emulated stenosis phase. Thigh compressions did not affect the pulse-transit time, but prolonged the time to the peak perfusion wave. Segmentation of the perfusion upstroke into two phases, at the time point of maximum acceleration (MAT), revealed that arterial compression prolonged only the initial slow phase duration (SPd). The MAT and SPd were proportional to the emulated stenosis severity and detected the arterial stenosis with high sensitivity (> 93%) and specificity (100%). The SPd increased from 46.4 ± 21.2 ms at baseline to 75.4 ± 38.5 ms and 145 ± 39 ms under 45 mmHg and 90 mmHg compressions (p < 0.001), without affecting the pulse-transit time. The novel method and indices can identify and grade the emulated arterial stenosis with high accuracy and may assist in differentiating between focal arterial stenosis and widespread arterial hardening.
Identifiants
pubmed: 37985616
doi: 10.1007/s13239-023-00686-y
pii: 10.1007/s13239-023-00686-y
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
774-785Subventions
Organisme : united states - israel binational science foundation
ID : 2013040
Informations de copyright
© 2023. The Author(s) under exclusive licence to Biomedical Engineering Society.
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