title: Do radial arterial pressure curves have diagnostic validity for identify severe aortic stenosis?
abstract: 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.
authors.affiliation: Department of Anesthesiology and ICM, Kawasaki Medical School, 577 Matsushima, Kurashiki 701-0192, Japan. naughty7@ybb.ne.jp
authors.forename: Naoki
authors.initials: N
authors.lastname: Yoshioka
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Fujita
authors.forename: Takeshi
authors.initials: T
authors.lastname: Yasukawa
authors.forename: Itsuro
authors.initials: I
authors.lastname: Sano
authors.forename: Masako
authors.initials: M
authors.lastname: Kiso
authors.forename: Masayuki
authors.initials: M
authors.lastname: Nakayama
authors.forename: Yuka
authors.initials: Y
authors.lastname: Yoshida
mesh_terms: 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