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Photoplethysmographic Waveforms Recorded from Patients with Untreated Hypertension

Received: 13 August 2015     Accepted: 22 August 2015     Published: 2 September 2015
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Abstract

The goal of this study was to establish whether changes in microvascular perfusion play an important role in the development of hypertension. To achieve this goal, we measured the photoplethysmographic waveforms recorded from the fingertips of patients with untreated hypertension. The photoplethysmographic waveforms were obtained from 60 healthy, normotensive male controls (NTs) and 30 untreated hypertensive male patients (HTs). The NTs were divided into two groups: a younger NT group (age 20 to 40 years, 30 individuals) and an older NT group (age 40 to 60 years, 30 individuals). The PPG waveform displayed a steep rise and a notch on the falling slope in the younger NT group. And for younger subjects, there were two positive waves (P1 and P2) and one negative wave (V).In the older NT group, a more gradual rise and fall was observed. For the HT group, no pronounced dicrotic notch was observed. A program was used to calculate the P2/P1 and P2/V ratios. The P2/P1 and P2/V ratios can indicate the perfusion to the fingertips during cardiac diastole. There were no significant differences in P2/P1 between the older NT group and HTs (0.37±0.07 versus 0.33±0.05, p>0.05).The P2/V ratios were significantly different between the older NT group and HTs (0.93±0.11 versus 0.59±0.08, p<0.05). These results indicate that there is a decrease in perfusion to the fingertips in hypertensive subjects during cardiac diastole.

Published in Clinical Medicine Research (Volume 4, Issue 5)
DOI 10.11648/j.cmr.20150405.18
Page(s) 163-167
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2015. Published by Science Publishing Group

Keywords

Hypertension, Microcirculation, Systemic Vascular Resistance, Endothelium, Arteriovenous Anastomoses, Photoplethysmography

References
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[2] Allen J.Photoplethysmography and its application in clinical physiological measurement.Physiol Meas. 2007 Mar; 28(3):R1-39. Epub 2007 Feb 20.
[3] Shelley KH. Photoplethysmography: beyond the calculation of arterial oxygen saturation and heart rate. Anesthesia and analgesia. 2007 Dec; 105(6 Suppl):S31-6, tables of contents.
[4] K Abo Alam. Fuzzy Logic Hemoglobin Sensors. Online-Ressource.2011.
[5] Middleton PM, Chan GS, Steel E.Fingertip photoplethysmographic waveform variability and systemic vascular resistance in intensive care unit patients.Med Biol Eng Comput. 2011 Aug; 49(8):859-66. Epub 2011 Feb 22.
[6] Allen J, Murray A. Age-related changes in the characteristics of the photoplethysmographic pulse shape at various body sites. Physiol Meas. 2003 May; 24 (2):297-307.
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[8] Aymen A Awad, Ala S Haddadin. The relationship between the photoplethysmographic waveform and systemic vascular resistance. Journal of Clinical Monitoring and Computing. 01/2008; 21(6):365-72. DOI: 10.1007/s10877-007-9097-5.
[9] Agnoletti D, Millasseau SC, topouchian J. Pulse wave analysis with two tonometric devices: a comparison study. Physiol Meas. 2014 Sep; 35(9):1837-48.doi: 10.1088/0967-3334/35/9/1837. Epub 2014 Aug 26.
[10] Lee QY, Chan GS, Redmond SJ, Middleton PM. Multivariate classification of systemic vascular resistance using photoplethysmography. Physiol Meas. 2011 Aug; 32(8):1117-32. doi: 10.1088/0967-3334/32/8/008. Epub 2011 Jun 21.
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[14] Middleton PM1, Chan GS, Steel E. Fingertip photoplethysmographic waveform variability and systemic vascular resistance in intensive care unit patients. Med Biol Eng Comput. 2011 Aug; 49(8):859-66. doi: 10.1007/s11517-011-0749-8. Epub 2011 Feb 22.
[15] Rozen WM, Chubb D. Macrovascular arteriovenous shunts (MAS): a newly identified structure in the abdominal wall with implications for thermoregulation and free tissue transfer. J Plast Reconstr Aesthet Surg. 2010 Aug; 63(8):1294-9. Epub 2009 Jul 3.
[16] Hales JR, Jessen C, Fawcett AA, King RB.Skin AVA and capillary dilatation and constriction induced by local skin heating. Pflugers Arch. 1985 Jul;404(3):203-7.
[17] Hales JR, Fawcett AA, Bennett JW, Needham AD. Thermal control of blood flow through capillaries and arteriovenous anastomoses in skin of sheep. Pflugers Arch. 1978 Dec 15;378(1):55-63.
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[19] Yanchun H. Shenju S. Lijun Z. Jilie C. Hypertension and microcirculation shunt vessel. China Foreign Medical Treatment.2009.19.002
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  • APA Style

    Yanchun Hu, Yanxia Hu, Shenju Song. (2015). Photoplethysmographic Waveforms Recorded from Patients with Untreated Hypertension. Clinical Medicine Research, 4(5), 163-167. https://doi.org/10.11648/j.cmr.20150405.18

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    ACS Style

    Yanchun Hu; Yanxia Hu; Shenju Song. Photoplethysmographic Waveforms Recorded from Patients with Untreated Hypertension. Clin. Med. Res. 2015, 4(5), 163-167. doi: 10.11648/j.cmr.20150405.18

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    AMA Style

    Yanchun Hu, Yanxia Hu, Shenju Song. Photoplethysmographic Waveforms Recorded from Patients with Untreated Hypertension. Clin Med Res. 2015;4(5):163-167. doi: 10.11648/j.cmr.20150405.18

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  • @article{10.11648/j.cmr.20150405.18,
      author = {Yanchun Hu and Yanxia Hu and Shenju Song},
      title = {Photoplethysmographic Waveforms Recorded from Patients with Untreated Hypertension},
      journal = {Clinical Medicine Research},
      volume = {4},
      number = {5},
      pages = {163-167},
      doi = {10.11648/j.cmr.20150405.18},
      url = {https://doi.org/10.11648/j.cmr.20150405.18},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.cmr.20150405.18},
      abstract = {The goal of this study was to establish whether changes in microvascular perfusion play an important role in the development of hypertension. To achieve this goal, we measured the photoplethysmographic waveforms recorded from the fingertips of patients with untreated hypertension. The photoplethysmographic waveforms were obtained from 60 healthy, normotensive male controls (NTs) and 30 untreated hypertensive male patients (HTs). The NTs were divided into two groups: a younger NT group (age 20 to 40 years, 30 individuals) and an older NT group (age 40 to 60 years, 30 individuals). The PPG waveform displayed a steep rise and a notch on the falling slope in the younger NT group. And for younger subjects, there were two positive waves (P1 and P2) and one negative wave (V).In the older NT group, a more gradual rise and fall was observed. For the HT group, no pronounced dicrotic notch was observed. A program was used to calculate the P2/P1 and P2/V ratios. The P2/P1 and P2/V ratios can indicate the perfusion to the fingertips during cardiac diastole. There were no significant differences in P2/P1 between the older NT group and HTs (0.37±0.07 versus 0.33±0.05, p>0.05).The P2/V ratios were significantly different between the older NT group and HTs (0.93±0.11 versus 0.59±0.08, p<0.05). These results indicate that there is a decrease in perfusion to the fingertips in hypertensive subjects during cardiac diastole.},
     year = {2015}
    }
    

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  • TY  - JOUR
    T1  - Photoplethysmographic Waveforms Recorded from Patients with Untreated Hypertension
    AU  - Yanchun Hu
    AU  - Yanxia Hu
    AU  - Shenju Song
    Y1  - 2015/09/02
    PY  - 2015
    N1  - https://doi.org/10.11648/j.cmr.20150405.18
    DO  - 10.11648/j.cmr.20150405.18
    T2  - Clinical Medicine Research
    JF  - Clinical Medicine Research
    JO  - Clinical Medicine Research
    SP  - 163
    EP  - 167
    PB  - Science Publishing Group
    SN  - 2326-9057
    UR  - https://doi.org/10.11648/j.cmr.20150405.18
    AB  - The goal of this study was to establish whether changes in microvascular perfusion play an important role in the development of hypertension. To achieve this goal, we measured the photoplethysmographic waveforms recorded from the fingertips of patients with untreated hypertension. The photoplethysmographic waveforms were obtained from 60 healthy, normotensive male controls (NTs) and 30 untreated hypertensive male patients (HTs). The NTs were divided into two groups: a younger NT group (age 20 to 40 years, 30 individuals) and an older NT group (age 40 to 60 years, 30 individuals). The PPG waveform displayed a steep rise and a notch on the falling slope in the younger NT group. And for younger subjects, there were two positive waves (P1 and P2) and one negative wave (V).In the older NT group, a more gradual rise and fall was observed. For the HT group, no pronounced dicrotic notch was observed. A program was used to calculate the P2/P1 and P2/V ratios. The P2/P1 and P2/V ratios can indicate the perfusion to the fingertips during cardiac diastole. There were no significant differences in P2/P1 between the older NT group and HTs (0.37±0.07 versus 0.33±0.05, p>0.05).The P2/V ratios were significantly different between the older NT group and HTs (0.93±0.11 versus 0.59±0.08, p<0.05). These results indicate that there is a decrease in perfusion to the fingertips in hypertensive subjects during cardiac diastole.
    VL  - 4
    IS  - 5
    ER  - 

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Author Information
  • Yanchun Hu, The Fifth People's Hospital, Jinan City, China

  • Yanxia Hu, Center for Disease Control and Prevention, Jinan City, China

  • Shenju Song, The Fifth People's Hospital, Jinan City, China

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