title: Arterial wave reflections during the menstrual cycle of healthy women: a reproducibility study.
abstract: Increased wave reflection is an independent factor associated with cardiovascular diseases, risk, and mortality. The influence of the menstrual cycle on wave reflections and particularly on the reproducibility of their measurement has never been examined. The aim of the present study was to examine the reproducibility and variability of wave reflection indices in premenopausal healthy women during their menstrual cycle. Thirty-two women were examined at 3 phases of their menstrual cycle: days 1 to 2 (menstrual phase), days 6 to 14 (late follicular), and days 4 to 7 after ovulation (early luteal phase). Applanation tonometry of the radial artery and aortic pulse wave analysis were performed for the calculation of augmentation pressure, augmentation index, and timing of reflected waves. Reproducibility of these measures was evaluated by intraclass correlation coefficient and Bland-Altman analysis, whereas ANOVA was performed to assess their variability during the menstrual cycle. The SD of augmentation index differences between repeated measurements within the menstrual cycle ranged from 7.6% to 9.9%. Bland-Altman analysis indicated no evidence of systemic bias and no trend for the reproducibility of measurements to vary with their underlying mean value. Intraclass correlation coefficient indicated a moderate reproducibility of augmentation index and augmentation pressure (>0.80) and a rather low reproducibility for timing of reflected waves (0.43). Mean augmentation pressure, augmentation index, and timing of reflected waves did not vary significantly during the menstrual cycle (ANOVA). Measurement of wave reflections at the same phase of the menstrual cycle or statistical adjustment could be suggested for optimal study design and data interpretation.
authors.affiliation: Biomedical Engineering Unit, 1st Department of Cardiology, Hippokration Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece. theopap@mail.ntua.gr
authors.forename: Theodore G
authors.initials: TG
authors.lastname: Papaioannou
authors.forename: Kimon S
authors.initials: KS
authors.lastname: Stamatelopoulos
authors.forename: George
authors.initials: G
authors.lastname: Georgiopoulos
authors.forename: Charalambos
authors.initials: C
authors.lastname: Vlachopoulos
authors.forename: Stellios
authors.initials: S
authors.lastname: Georgiou
authors.forename: Marita
authors.initials: M
authors.lastname: Lykka
authors.forename: Irene
authors.initials: I
authors.lastname: Lambrinoudaki
authors.forename: Christos M
authors.initials: CM
authors.lastname: Papamichael
authors.forename: Christodoulos I
authors.initials: CI
authors.lastname: Stefanadis
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D001783:Blood Flow Velocity; D001794:Blood Pressure / Q000502:physiology*; D001916:Brachial Artery / Q000502:physiology; D015331:Cohort Studies; D016001:Confidence Intervals; D005260:Female; D005498:Follicular Phase / Q000502:physiology; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D008183:Luteal Phase / Q000502:physiology; D008365:Manometry / Q000379:methods; D008597:Menstrual Cycle / Q000502:physiology*; D011336:Probability; D011673:Pulsatile Flow; D017534:Radial Artery / Q000502:physiology; D012016:Reference Values; D015203:Reproducibility of Results; D014666:Vasomotor System / Q000502:physiology*