Multi-Site Pulse Transit Times, Beat-to-Beat Blood Pressure, and Isovolumic Contraction Time at Rest and Under Stressors
Marco Di Rienzo, Alberto Avolio, Giovannibattista Rizzo, Zeynep Melike Isilay Zeybek, Luisa Cucugliato
Abstract
This study investigates the beat-to-beat relationships among Pulse Transit Times (PTTs) and Pulse Arrival Times (PATs) concomitantly measured from the heart to finger, ear and forehead vascular districts, and their links with continuous finger blood pressure and isovolumic contraction time (IVCT). These aspects were explored in 22 young volunteers at rest and during cold pressure test (CPT, thermal stress), handgrip (HG, isometric exercise) and cyclo-ergometer pedalling (CYC, dynamic exercise). The starting point of the PTT measures was detected by the seismocardiogram. Results indicate that PTTs measured at the ear, forehead and finger districts are uncorrelated each other at rest, and during CPT and HG. The stressors produced district-dependent changes in the PTT variability. Only the dynamic exercise was able to induce significant changes with respect to rest in the PTTs mean values (-40%, -36% and -17%, respectively for PTT<sub>ear</sub>, PTT<sub>fore</sub>, PTT<sub>finger</sub>), and synchronize their modulations. Similar trends were observed in the PATs. IVCT decreased during the application of stressors with a minimum at CYC (-25%) reflecting an augmented heart contractility. The increase in blood pressure (BP) at CPT was greater than that at CYC (137 vs. 128 mmHg), but the correlations between beat-to-beat transit times and BP were maximal at CYC (PAT showed a higher correlation than PTT; correlations were greater for systolic than for diastolic BP). This suggests that pulse transit times do not always depend directly on the beat-to-beat BP values but, under specific conditions, on other factors and mechanisms that concomitantly also influence BP.