Do radial arterial pressure curves have diagnostic validity for identify severe aortic stenosis?
Abstract
PURPOSE: 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 cm(2)) 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.
CONCLUSION: 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.
Links
Authors
Yoshioka N, Fujita Y, Yasukawa T, Sano I, Kiso M, Nakayama M, Yoshida Y
Institution
Department of Anesthesiology and ICM, Kawasaki Medical School, 577 Matsushima, Kurashiki, 701-0192, Japan, naughty7@ybb.ne.jp.
Source
Journal of anesthesia : 2010 Jan 15 pgPub Type(s)
JOURNAL ARTICLELanguage
ENG
PubMed ID
20082101
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