Determination of Appropriate Recording Force for Non-Invasive Measurement of Arterial Pressure Pulses

Abstract
1. Non-invasive recording techniques of the arterial pressure pulse will distort the arterial wall and may alter pulse wave measurements. We hypothesized that intersubject variability of these measurements would be reduced if recording forces were normalized to reflect individualized arterial occlusion forces. 2. In 10 normal male subjects (age 24 ± 1 years), brachial, radial and finger arterial pressure pulses were recorded simultaneously using volume displacement pulse transducers (Fukuda TY-303) and a finger pressure monitoring system (Finapres, Ohmeda 2300) and were made at 2, 5 and 10–100% (10% increments) of the brachial arterial force associated with marked distortion of finger pulsations. Forces were applied at the brachial site in a randomized order while a constant 1.8 N force was applied at the radial artery site. Pressure pulses were analysed using the discrete fast Fourier transform. 3. Pulse amplitude, contour, wave velocity and relative transmission ratios remained relatively constant until the brachial artery recording force exceeded 59.9 ± 0.3% of the largest recording force used in each subject (7.14 ± 0.75 N). The finger pulse pressures (P < 0.0001), radial pulse amplitudes (P < 0.0001) and contours (harmonics 2–6, P < 0.003), pulse wave velocity (P < 0.021) and relative transmission ratios (harmonics 3–7, P < 0.01) then decreased with higher recording forces. 4. To avoid distortion, non-invasive recordings of arterial pressure pulse amplitude, contour, pressure wave velocity and relative transmission ratios along a peripheral arterial segment should use recording forces of less than 60% of the force associated with marked distortion of finger pulsations.