The Challenges in Scoring Hypopneas in Children: Is Pulse Wave Amplitude Drop the Answer?

Introduction: Peripheral arterial vasoconstriction during mental stress (MS) has been associated with mental stress-induced myocardial ischemia, which in turn has been linked with worse cardiovascular outcomes. It is unknown whether the magnitude of peripheral vasoconstriction with MS is predictive of long term outcomes. Hypothesis: We hypothesized that greater peripheral arterial vasoconstriction during MS would be associated with adverse events among patients with coronary artery disease (CAD). Methods: Four hundred sixty-three patients with stable CAD and normal left ventricular function, (age 63±9, 75% male, 27% Black, EF 60±8 %) underwent MS testing with a standardized public speaking stressor. Digital pulse wave amplitude was continuously measured at baseline and during MS using peripheral arterial tonometry (PAT), and the PAT ratio of pulse wave amplitude (during mental stress/ baseline) was calculated. Cox proportional hazard models were calculated to examine the association between the PAT ratio and outcomes. Results: Median PAT ratio during MS was 0.68, indicating 32% average constriction with MS compared to rest. Subjects with greater peripheral constriction [low (<median) PAT ratio] were more likely to be male (80% vs. 70%, P=0.008) compared to those with PAT ratio ≥median, but their risk factor profiles were similar. During 2.8±0.5 year follow-up, 64 patients had adverse cardiac events including 7 cardiovascular deaths, 19 MI, and 54 revascularization events. After adjusting for age, sex, race, hypertension, diabetes, current smoking status, and prior MI, those with low PAT ratio had a greater risk of CV death/MI (HR[hazard ratio] 2.49, 95% CI [1.04-5.99]) and CV death/MI/revascularization (HR 1.77, 95% CI [1.03-3.04]) compared to those with high PAT ratio. Conclusion: Greater peripheral arterial vasoconstriction with MS is associated with a higher risk of adverse cardiovascular outcomes in patients with CAD.

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Plethysmographic pulse wave amplitude and future leg arteriosclerosis

Atherosclerosis ◽

10.1016/0021-9150(94)05427-k ◽

1995 ◽

Vol 113 (1) ◽

pp. 55-62 ◽

Cited By ~ 6

Author(s):

M Ögren

Keyword(s):

Wave Amplitude ◽

Pulse Wave ◽

Pulse Wave Amplitude

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Environmental noise-induced cardiovascular responses during sleep

SLEEP ◽

10.1093/sleep/zsab302 ◽

2021 ◽

Author(s):

Bastien Lechat ◽

Hannah Scott ◽

Felix Decup ◽

Kristy L Hansen ◽

Gorica Micic ◽

...

Keyword(s):

Wind Farm ◽

Wave Amplitude ◽

Sound Pressure ◽

Noise Exposure ◽

Pulse Wave ◽

Traffic Noise ◽

Cardiovascular Responses ◽

Environmental Noise ◽

Pulse Wave Amplitude ◽

Sound Pressure Levels

Abstract Study Objectives This study was designed to test the utility of cardiovascular responses as markers of potentially different environmental noise disruption effects of wind farm compared to traffic noise exposure during sleep. Methods Twenty participants underwent polysomnography. In random order, and at six sound pressure levels from 33 dBA to 48 dBA in 3 dB increments, three types of wind farm and two types of road traffic noise recordings of 20-sec duration were played during established N2 or deeper sleep, each separated by 20 seconds without noise. Each noise sequence also included a no-noise control. Electrocardiogram and finger pulse oximeter recorded pulse wave amplitude changes from the pre-noise onset baseline following each noise exposure and were assessed algorithmically to quantify the magnitude of heart rate and finger vasoconstriction responses to noise exposure. Results Higher sound pressure levels were more likely to induce drops in pulse wave amplitude. Sound pressure levels as low as 39 dBA evoked a pulse wave amplitude response (Odds ratio [95% confidence interval]; 1.52 [1.15, 2.02]). Wind farm noise with amplitude modulation was less likely to evoke a pulse wave amplitude response than the other noise types, but warrants cautious interpretation given low numbers of replications within each noise type. Conclusion These preliminary data support that drops in pulse wave amplitude are a particularly sensitive marker of noise-induced cardiovascular responses during. Larger trials are clearly warranted to further assess relationships between recurrent cardiovascular activation responses to environmental noise and potential long-term health effects.

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0860 Pulse Wave Amplitude Drops During Sleep: Reference Values And Clinical Associations In A General Population

SLEEP ◽

10.1093/sleep/zsz067.858 ◽

2019 ◽

Vol 42 (Supplement_1) ◽

pp. A345-A345

Author(s):

Camila Hirotsu ◽

Pedro Marques-Vidal ◽

Peter Vollenweider ◽

Monica Betta ◽

Giulio Bernardi ◽

...

Keyword(s):

General Population ◽

Reference Values ◽

Wave Amplitude ◽

Pulse Wave ◽

Pulse Wave Amplitude ◽

Clinical Associations

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Effect of heat-induced pain stimuli on pulse transit time and pulse wave amplitude in healthy volunteers

Physiological Measurement ◽

10.1088/0967-3334/37/1/52 ◽

2015 ◽

Vol 37 (1) ◽

pp. 52-66 ◽

Cited By ~ 4

Author(s):

Marit H N van Velzen ◽

Arjo J Loeve ◽

Minke C Kortekaas ◽

Sjoerd P Niehof ◽

Egbert G Mik ◽

...

Keyword(s):

Healthy Volunteers ◽

Transit Time ◽

Wave Amplitude ◽

Pulse Wave ◽

Pulse Transit Time ◽

Pulse Wave Amplitude ◽

Pain Stimuli

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Reactions to Cold Exposure Emphasize the Need for Weather Protection in Prehospital Care: An Experimental Study

Prehospital and Disaster Medicine ◽

10.1017/s1049023x00003940 ◽

2006 ◽

Vol 21 (5) ◽

pp. 316-320 ◽

Cited By ~ 7

Author(s):

Niina S. Lintu ◽

M. Health ◽

Matti A.K. Mattila ◽

Jaana A. Holopainen ◽

Mari Koivunen ◽

...

Keyword(s):

Tympanic Membrane ◽

Cold Exposure ◽

Room Temperature ◽

Wave Amplitude ◽

Pulse Wave ◽

Prehospital Care ◽

Emg Activity ◽

Pulse Wave Amplitude ◽

Vital Functions ◽

Skin Temperatures

AbstractIntroduction:Exposure to cold temperature is a serious but often neglected problem in prehospital care. It not only is an uncomfortable, subjective experience, but it also can cause severe disturbances in vital functions, gradually leading to hypothermia.Objective:The aim of this study was to examine healthy subjects'physiological and subjective reactions to cold exposure (30 minutes at -5°C in the a climatic chamber) while they were lying in a protective covering.Methods:Healthy volunteers (n = 20) participated in the experiment, which consisted of a 10-minute stabilization period of vital functions at room temperature (23°C), 30 minutes of cold exposure (-5°C), and a 30-minute recovery period at room temperature. Subjects lay supinely in protective covering during the entire experiment. Skin temperatures, oxygen saturation, pulse rates, pulse wave amplitude in the middle finger, and surface electromyography (EMG) activity of the major pectoral muscle were recorded continuously during the test. Before and immediately after the cold exposure, tympanic membrane temperatures were measured. In addition, subjects were asked to estimate cold using a standard scale.Results:During the cold exposure, the decrease in tympanic membrane temperature was not significant.The pulse wave amplitude in the finger decreased sharply upon entering the cold chamber. Skin temperatures, especially of the fingers and toes, decreased during the cold exposure.There were no clear signs of shivering in electromyographic recordings. Subjective cold feelings followed decreasing skin temperatures. Skin temperatures did not return quickly. Even 30 minutes after the exposure, all the skin temperatures still had not returnedto normal levels.However, subjective cold feeling was relieved immediately.Conclusions:Cold exposure provoked immediate protective vasoconstriction in the peripheral compartment, which caused linear decreases of local skin temperatures. This probably was triggered from the unprotected face and upper respiratory areas.

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