title: Second derivative of the finger arterial pressure waveform: an insight into dynamics of the peripheral arterial pressure pulse.
abstract: The study investigated second derivative of the finger arterial pressure waveform (SDFAP) in 120 healthy middle-aged subjects and in 24 subjects with essential hypertension. SDFAP consists of 5 sequential waves 'a'-'e'. Their normalized magnitudes (B/A, C/A, D/A, and E/A) were calculated. In multivariate regression analysis, B/A and C/A correlated only with age. D/A independently correlated with age, heart period, mean blood pressure (MBP), body height, and gender. E/A independently correlated with age and MBP. D/A and E/A were higher (0.42+/-0.16 vs. 0.33+/-0.14, p = 0.05 and 0.63+/-0.15 vs. 0.45+/-0.14, p < 0.001), while B/A and C/A were lower (1.04+/-0.16 vs. 1.20+/-0.17, p = 0.002 and 0.09+/-0.15 vs. 0.26+/-0.20, p = 0.001) in hypertensives compared to sex- and age-matched controls. After the adjustment for MBP, heart period, and body mass index (ANCOVA), independent discriminative power was preserved only for indices B/A and C/A (p = 0.001 and 0.021, respectively). Therefore, B/A and C/A provide additional information about simple clinical characteristics and might reflect the structural alteration of the arterial wall in hypertensive subjects.
authors.affiliation: Third Department of Internal Medicine, First School of Medicine, General University Hospital, Charles University, Prague, Czech Republic. jan_simek@hotmail.com
authors.forename: J
authors.initials: J
authors.lastname: Simek
authors.forename: D
authors.initials: D
authors.lastname: Wichterle
authors.forename: V
authors.initials: V
authors.lastname: Melenovský
authors.forename: J
authors.initials: J
authors.lastname: Malík
authors.forename: S
authors.initials: S
authors.lastname: Svacina
authors.forename: J
authors.initials: J
authors.lastname: Widimský
mesh_terms: D000328:Adult; D000465:Algorithms; D001794:Blood Pressure; D001795:Blood Pressure Determination / Q000379:methods*; D003936:Diagnosis, Computer-Assisted / Q000379:methods*; D005260:Female; D005385:Fingers / Q000098:blood supply*; D006801:Humans; D006973:Hypertension / Q000175:diagnosis* / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D009716:Numerical Analysis, Computer-Assisted; D011673:Pulsatile Flow; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013223:Statistics as Topic