Second Derivative of the
Finger Arterial Pressure Waveform: An Insight into Dynamics of
the Peripheral Arterial Pressure Pulse
J. ŠIMEK, D. WICHTERLE1, V. MELENOVSKÝ2,
J. MALÍK, Š. SVAČINA,
J. WIDIMSKÝ
Third and 1Second Department of Internal Medicine,
First School of Medicine, General University Hospital, Charles
University, Prague, Czech Republic, 2Cardiology
Division, Department of Medicine, Johns Hopkins Medical
Institutions, Baltimore, Maryland, USA
Received August 17, 2004
Accepted November 3, 2004
On-line available January 10, 2005
Summary
The study investigated second derivative of the finger arterial
pressure waveform (SDFAP) in 120 healthy middle-aged subjects
and in 24 subjects with essential hypertension. SDFAP consists
of 5 sequential waves ‘a’-‘e’. Their normalized magnitudes (B/A,
C/A, D/A, and E/A) were calculated. In multivariate regression
analysis, B/A and C/A correlated only with age. D/A
independently correlated with age, heart period, mean blood
pressure (MBP), body height, and gender. E/A independently
correlated with age and MBP. D/A and E/A were higher (0.42±0.16
vs. 0.33±0.14, p=0.05 and 0.63±0.15 vs. 0.45±0.14, p<0.001),
while B/A and C/A were lower (1.04±0.16 vs. 1.20±0.17, p=0.002
and 0.09±0.15 vs. 0.26±0.20, p=0.001) in hypertensives compared
to sex- and age-matched controls. After the adjustment for MBP,
heart period, and body mass index (ANCOVA), independent
discriminative power was preserved only for indices B/A and C/A
(p = 0.001 and 0.021, respectively). Therefore, B/A and C/A
provide additional information about simple clinical
characteristics and might reflect the structural alteration of
the arterial wall in hypertensive subjects.
Key words
Pulse wave analysis • Finapres • Second derivative • Essential
hypertension • Aging • Augmentation index
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