By Gaetano D Gargiulo; Alistair McEwan
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Functional and structural changes in the arterial wall can be used as early marker for the hypertensive and cardiac diseases. Blood flow is the key to monitor the cardiovascular health condition since it is generated and restrict within such system. Currently the most widely used method for haemodynamic parameters detecting is invasive thermo-dilution method. Impedance-cardiography is the most commonly used non-invasive method nowadays; however, it is too complex for clinical routine check. Pulse wave analysis is an innovative method in the market to do fast and no burden testing (Zhang et al.
The pulse wave analysis result is highly repeatable in this condition. Actually the similarity of pulse waveforms doesn’t change a lot under similar cardiovascular health condition even the heart rate and pulse strength changed, so waveform analysis can fit in different scenarios other than specific testing environment. There are several classification system for the pulse wave. In the paper “Characteristics of the dicrotic notch of the arterial pulse wave in coronary heart diease”, Tomas treat the notch as the indicator and classify pulse wave into four categories as following: Class I: A distinct incisura is inscribed on the downward slop of the pulse wave Class II: No incisura develops but the line of descent becomes horizontal Class III: No notch is present but a well-defined change in the angle of descent is observed Class IV: No evidence of a notch is seen 28 Advanced Biomedical Engineering Class I Class II Class III Class VI Fig.
Pulse wave form from a patient with acute anterior myocardial infarction The above pulse wave was taken from a male patient at department of cardiology. He had a history of myocardial infarction for 8 years and came to the clinic again for angina pectoris. His cardiac function was rated as NYHA level IV and had to sleep in bed. The waveform is a typical one with poor cardiac function. The systolic part is very sharp and narrow that suggests very low Cardiac Output. The diastolic component is lost since the weak pulse.
Advanced biomedical engineering by Gaetano D Gargiulo; Alistair McEwan