The key of Ankle-brachial index (ABI) measurement is the synchronous measurement of four limbs' systolic blood pressures. In this paper is analyzed the inadequacy of the modern blood pressure measurement technologies used in the ABI measurement process. Special emphasis is laid on the principles and characteristics of the double-layer cuffs technology. The research orientation, the existing problems, and the way toward improvement are discussed.
Ankle ; blood supply ; Ankle Brachial Index ; instrumentation ; methods ; Automation ; Blood Pressure ; physiology ; Blood Pressure Determination ; methods ; Brachial Artery ; physiology ; Humans ; Peripheral Vascular Diseases ; diagnosis ; physiopathology ; Regional Blood Flow

According to the pulse-wave theory, the authors developed a new non-invasive instrument for measuring arterial elastic function. It collects the pulse waveforms from the arteries of four limbs as well as from the radial arteries of carpus. After signal pre-processing, it calculates the arterial elastic parameters by the pre-prepared algorithm and program. Individual parameters such as pulse wave velocity (PWV), ankle-brachial index (ABI), systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate (HR)can be obtained. At the same time, a series of clinical trials were conducted with reference to PWV and ABI, which confirmed the validity, accuracy and reliability of the instrument. The instrument can be used to determine the differences between cardiovascular patients and normal persons, as well as the extent of atherosclerosis. At the same time it can reflect the situation of vascular obstruction and screen the peripheral arterial disease. Therefore, it is of some value to the epidemiological study, prevention and early detection of cardiovascular disease.
Aging ; physiology ; Ankle ; blood supply ; Arteries ; physiopathology ; Arteriosclerosis ; physiopathology ; Blood Pressure ; physiology ; Brachial Artery ; physiopathology ; Elasticity ; physiology ; Humans ; Hypertension ; physiopathology ; Pulsatile Flow ; physiology ; Pulse ; Systole

Arterial stiffness is an important contributor to the development of cardiovascular disease. We investigated the effect of short duration exercise using the treadmill test on arterial stiffness in the presence of coronary artery disease. We enrolled patients with and without coronary artery diseases (CAD and control group, 50 patients each) referred for treadmill testing. Brachial-ankle pulse wave velocity (baPWV) were measured before and after treadmill testing. Values of baPWV were significantly reduced at 10 min after exercise in both groups, more in the CAD group than in the control group (baseline baPWV and post-exercise change [cm/sec]: 1,527+/-245 and -132+/-155 in the CAD group, 1,439+/-202 and -77+/-93 in the control group, respectively, P for change in each group <0.001, P for difference in changes between the two groups <0.001). These findings persisted after adjusting for age, body mass index, systolic blood pressure, mean arterial pressure (MAP), MAP decreases, and baseline baPWV. Significant post-exercise baPWV reductions were observed in both groups, and more prominently in the CAD group. This finding suggests that short-duration exercise may effectively improve arterial stiffness even in patients with stable coronary artery disease.
Adult ; Aged ; Ankle/blood supply ; Ankle Brachial Index ; Arteries/*physiopathology ; Blood Flow Velocity ; Brachial Artery/physiology ; Coronary Artery Disease/diagnosis/*physiopathology/therapy ; Elasticity ; *Exercise Therapy ; Female ; Humans ; Male ; Middle Aged ; Predictive Value of Tests

BACKGROUNDPulse wave velocity and flow-mediated vasodilation (FMD) are widely used as noninvasive modalities for evaluating atherosclerosis. However, it is not known whether pulse wave velocity is related to FMD in patients with coronary artery disease (CAD). Therefore, the present study was designed to investigate the alteration in brachial-ankle pulse wave velocity (baPWV) and endothelial function in CAD patients.

METHODSThirty-three patients with CAD and thirty control subjects were recruited for this study. baPWV was measured non-invasively using a VP 1000 automated PWV/ABI analyzer (PWV/ABI, Colin Co. Ltd., Komaki, Japan). Endothelial function as reflected by FMD in the brachial artery was assessed with a high-resolution ultrasound device.

RESULTSbaPWV was increased in CAD patients compared with control subjects [(1756.1 +/- 253.1) cm/s vs (1495.3 +/- 202.3) cm/s, P < 0.01]. FMD was significantly reduced in CAD patients compared with control subjects [(5.2 +/- 2.1)% vs (11.1 +/- 4.4)%, P < 0.01]. baPWV correlated with FMD (r = -0.68, P < 0.001). The endothelium-independent vasodilation induced by sublingual nitroglycerin in the brachial artery was similar in the CAD group compared with the control group.

CONCLUSIONSCAD is associated with increased baPWV and endothelial dysfunction. Increased baPWV parallels diminished endothelial function. Our data therefore suggest that baPWV can be used as a noninvasive surrogate index in clinical evaluation of endothelial function.

Aged ; Ankle ; blood supply ; Blood Flow Velocity ; physiology ; Brachial Artery ; physiopathology ; Coronary Artery Disease ; physiopathology ; Endothelium, Vascular ; physiopathology ; Female ; Humans ; Male ; Middle Aged ; Vasodilation

PURPOSE: The aim of this study was to evaluate the effects of a smoking cessation education on endothelial function and carboxyhemoglobin levels in smokers with variant angina. METHODS: A nonequivalent control group pretest-posttest design was used. Participants were 60 male smokers with variant angina admitted to one hospital: the control group (30) between September and December, 2009, and the experimental group (30) between February and May, 2010. Endothelial function, as defined by flow-mediated vasodilation (FMD) of the brachial artery, and serum carboxyhemoglobin (COHb) were determined at baseline and at 3 months after the initiation of education in both groups. RESULTS: Three months after the program, smoking cessation was successful in 22 of the 30 smokers in the experimental group, but only in 4 of 30 smokers in the control group (p<.001). After the education, the experimental group showed a significant increase in FMD, and a significant decreased in serum COHb compared with the control group. CONCLUSION: The findings indicate that this smoking cessation education program is effective for hospitalized smokers with variant angina.
Adult ; Angina Pectoris, Variant/blood/*physiopathology ; Brachial Artery/physiology ; Carboxyhemoglobin/*analysis ; Endothelium, Vascular/*physiology ; Humans ; Male ; Middle Aged ; *Program Evaluation ; Smoking/psychology ; *Smoking Cessation ; Vasodilation

As there are a number of ankle arteries and some of them can not be blocked completely under higher pressure from the external inflate cuff, we can not accurately identify the starting point of the pulse wave, so the errors of lower limb systolic blood pressure measurement take place and affect the accuracy of ankle-brachial index in diagnosing vascular disease. In this paper, we constructed delay vectors from the data we already collected from lower limb pulse wave and formed an embedding matrix; thus solving the problem of inadequate sensor dimensions. We extracted a single arterial pulse wave through the blind signal separation on the basis of embedding matrix, and we identified the lower limb systolic blood pressure corresponding to the starting point. Simulation and clinical experiments show the method can be used to separate the wave signals of ankle artery which contains information of systolic blood pressure. It improves the accuracy of lower limb systolic blood pressure measurement and hence provides accurate data for the clinical diagnosis of arterial disease.
Algorithms ; Ankle ; blood supply ; Blood Pressure ; Blood Pressure Determination ; methods ; Brachial Artery ; physiology ; Humans ; Leg ; blood supply ; Pulsatile Flow ; physiology ; Signal Processing, Computer-Assisted

The superficial brachial artery (SBA), a branch of the axillary artery, is one of the most common arterial variations in this area. While it is more vulnerable to accidental arterial injection or injury, it could be useful for the nourishment of a medial arm skin free flap. To analyze the relationship between the SBA of axillary origin and segmental variation of the axillary artery, we dissected 304 arms of Korean cadavers. We found an SBA of axillary origin in 12.2% of cadaveric arms. Unilateral occurrence was detected in 16 cadavers and bilateral in 10. SBAs gave rise to radial and ulnar arteries in the cubital fossa (8.9%), continued in the forearm as the radial artery (2.3%), or ended in the upper arm (1.0%). The SBA ended as ulnar artery was not found in any of the cadavers. The bifurcation of the SBA into the radial and ulnar arteries, presence of an SBA that ends in the upper arm, and the lack of continuation as the ulnar artery are characteristics of SBAs in Korean cadavers.
Arm/*blood supply ; Axillary Artery/anatomy & histology ; Brachial Artery/*anatomy & histology/*physiology ; Cadaver ; Female ; Humans ; Korea ; Male ; Median Nerve/blood supply ; Models, Anatomic ; Radial Artery/anatomy & histology ; Ulnar Artery/anatomy & histology

The aim of this study was to determine the normal value of brachial-ankle pulse wave velocity (baPWV) and carotid-femoral pulse wave velocity (cfPWV) according to age group, gender, and the presence of cardiovascular risk factors in healthy Koreans, and to investigate the association between PWV and risk factors such as prehypertension, dyslipidemia, smoking, and obesity. We measured an arterial stiffness in 110 normal subjects who were 20 to 69 yr-old with no evidence of cardiovascular disease, cerebrovascular accident or diabetes mellitus. The mean values of baPWV and cfPWV were 12.6 (+/-2.27) m/sec (13.1+/-1.85 in men, 12.1+/-2.51 in women; P=0.019) and 8.70 (+/-1.99) m/sec (9.34+/-2.13 in men, 8.15+/-1.69 in women; P=0.001), respectively. The distribution of baPWV (P<0.001) and cfPWV (P=0.006) by age group and gender showed an increase in the mean value with age. Men had higher baPWV and cfPWV than women (P<0.001). There was a difference in baPWV and cfPWV by age group on prehypertension, dyslipidemia, current smoking, or obesity (P<0.001). In multiple linear regression, age and prehypertension were highly associated with baPWV and cfPWV after adjustment for confounding factors (P<0.001). The present study showed that baPWV and cfPWV are associated with age, gender, and prehypertension in healthy Koreans.
Adult ; Age Factors ; Aged ; *Ankle Brachial Index ; Blood Pressure ; Brachial Artery/*physiology ; Cardiovascular Diseases/diagnosis/etiology/physiopathology ; Carotid Arteries/*physiology ; Female ; Femoral Artery/*physiology ; Humans ; Male ; Middle Aged ; Obesity/physiopathology ; Prehypertension/physiopathology ; Pulsatile Flow ; *Pulse Wave Analysis ; Republic of Korea ; Risk Factors ; Sex Factors ; Smoking ; Vascular Stiffness/physiology

OBJECTIVETo evaluate the therapeutic effects of Quyu Xiaoban Capsule (QYXBC) on endothelial dependent vascular relaxation (EDVR) function in patients with atherosclerosis (AS) with ultrasonic technique.

METHODSTested were the endothelial function and blood lipids of 42 patients with AS in the treated group and 30 healthy volunteers in the control group. And re-examination of these parameters was carried out on the AS patients after they had been treated with QYXBC for 10 months.

RESULTSBefore treatment, the reactive hyperemia induced changes in artery diameter in the treated group was significantly lower than that in the control group (P < 0.01), while insignificant difference was found between the two groups in response to nitroglycerin. In the treated group after treatment, with D%-R improved significantly (P < 0.01), total cholesterol (TC), triglyceride (TG) and low-density lipoprotein cholesterol (LDL-C) decreased by 16.3%, 5.6%, 10.2% respectively and high-density lipoprotein cholesterol (HDL-C) increased by 7.5%. EDVR was correlated negatively with the serum TC, LDL-C concentrations and the baseline brachial diameter (D(0)) (r = -0.41, -0.66, -0.59, respectively, all P < 0.01), but correlated positively with HDL-C (r = 0.62, P < 0.05). The ameliorative extent of EDVR was correlated positively to the decreased magnitude of TC and LDL-C concentrations (r = 0.67, 0.59, both P < 0.01).

CONCLUSIONQYXBC can lower the level of blood lipids and improve significantly EDVR function.

Adult ; Aged ; Brachial Artery ; physiology ; Carotid Artery Diseases ; diagnostic imaging ; drug therapy ; Cholesterol, HDL ; blood ; Cholesterol, LDL ; blood ; Drugs, Chinese Herbal ; administration & dosage ; adverse effects ; Endothelium, Vascular ; drug effects ; physiology ; Female ; Humans ; Male ; Middle Aged ; Phytotherapy ; Ultrasonography ; Vasodilation ; drug effects

Complement 1 (C1) inhibitor is an acute phase protein with anti-inflammatory properties. The aim of the present study was to elucidate the relationship between brachial ankle pulse wave velocity (baPWV), the parameter of arterial stiffness, and C1 inhibitor. One hundred subjects were randomly enrolled in this study. Data about baPWV, age, gender, hypertension, smoking, and body mass index (BMI) were measured. Blood tests for total cholesterol, low density lipoprotein, high density lipoprotein, triglycerides, hemoglobin A1c, erythrocyte sedimentation rate, C-reactive protein, complement 3, and C1 inhibitor were performed. Based on the Pearson correlation, the C1 inhibitor showed a positive relation to the baPWV (P<0.001). Multiple regression analysis revealed the significant predictors of baPWV were not only the conventional risk factors of arteriosclerosis and/or atherosclerosis, such as age (P<0.001), gender (P<0.001), hypertension (P<0.001), and BMI (P=0.006), but also the acute phase protein, C1 inhibitor (P=0.025). In conclusion, C1 inhibitor is associated with arterial stiffness through its association with increased inflammation.
Adolescent ; Adult ; Age Factors ; Aged ; Ankle/blood supply ; Ankle Brachial Index ; Blood Flow Velocity/physiology ; Blood Pressure/physiology ; Body Mass Index ; Brachial Artery/*physiology ; Complement C1 Inhibitor Protein/*metabolism ; Elasticity ; Female ; Humans ; Male ; Middle Aged ; Predictive Value of Tests ; Regression Analysis ; Risk Factors ; Sex Factors