Do radial arterial pressure curves have diagnostic validity for identify severe aortic stenosis?
OBJECTIVE
A pulsus parvus et tardus of the carotid artery, i.e., a small weak pulse with a delayed systolic peak, is a well-recognized clinical finding of aortic stenosis (AS). However, the diagnostic value of radial arterial pressure curves has not been specifically investigated. In this study, we investigated whether the radial arterial curves of patients with AS had distinguishable characteristics.


METHODS
We studied 17 AS patients (valve area less than 0.8 cm2) and 17 control patients. The durations for the following intervals were measured, from the ECG-R to the beginning of the arterial pressure wave upstroke (PTT(Up)), from the ECG-R to the peak of the arterial pressure (PTT(peak)), and the difference between PTT(peak) and PTT(Up) (T(Upstroke)).


RESULTS
The radial arterial pulse pressures did not differ significantly, indicating absence of a pulsus paruvus in the radial pressure of the AS patients. The PTT(Up) and PTT(peak) in the AS patients were 134 +/- 18 and 337 +/- 44 ms, respectively, while these values in the control patients were 143 +/- 21 and 286 +/- 64 ms. As a result of the differences in PTT(Up) and PTT(peak), the T(Upstroke) in the AS patients was greater than that in the control patients. The T(Upstroke) cutoff point that gave the maximal sensitivity (0.93) and specificity (0.65) was 156 ms.


CONCLUSIONS
Our study using the radial arterial curve validated a pulsus tardus as a diagnostic sign for severe AS, while the validity of a pulsus parvus as a diagnostic sign was not confirmed.
Yoshioka
Naoki
N
Department of Anesthesiology and ICM, Kawasaki Medical School, 577 Matsushima, Kurashiki 701-0192, Japan. naughty7@ybb.ne.jp
Fujita
Yoshihisa
Y
Yasukawa
Takeshi
T
Sano
Itsuro
I
Kiso
Masako
M
Nakayama
Masayuki
M
Yoshida
Yuka
Y
D000368:Aged; D000369:Aged, 80 and over; D001024:Aortic Valve Stenosis / Q000175:diagnosis*; D001794:Blood Pressure / Q000502:physiology*; D006801:Humans; D012372:ROC Curve; D017534:Radial Artery / Q000503:physiopathology*; D012680:Sensitivity and Specificity