Pulse wave transit time during exercise testing reflects the severity of heart disease in cardiac patients.

Takayanagi Y; Koike A; Kubota H; Wu L; Nishi I; Sato A; Aonuma K; Kawakami
Y; Ieda M.

Drug Discoveries & Therapeutics. 14(1):21-26, 2020 Mar 08.
VI 1

The pulse wave transit time (PWTT) is easily measured as the time from the
R wave of an electrocardiogram to the arrival of the pulse wave measured
by an oxygen saturation monitor at the earlobe. We investigated whether
the change of PWTT during exercise testing reflects cardiopulmonary
function. Eighty-nine cardiac patients who underwent cardiopulmonary
exercise testing (CPX) were enrolled. We analyzed the change of PWTT
during exercise and the relationship between the shortening of the PWTT
and CPX parameters. PWTT was significantly shortened from rest to peak
exercise (204.6 +/- 33.6 vs. 145.6 +/- 26.4 msec, p < 0.001) in all of the
subjects. The patients with heart failure had significantly higher PWTT at
peak exercise than the patients without heart failure (152.7 +/- 27.1 vs.
140.4 +/- 24.8 msec, p = 0.031). The shortening of PWTT from rest to peak
exercise showed significant positive correlations with the peak O2 uptake
(VO2) (r = 0.56, p < 0.001), anaerobic threshold (r = 0.40, p = 0.016),
and % increase of systolic blood pressure during exercise (r = 0.75, p <
0.001), and a negative correlation with the slope of the increase in
ventilation versus the increase in CO2 output (VE-VCO2 slope) (r = – 0.42,
p = 0.010) in the patients with heart failure. PWTT was shortened during
exercise as the exercise intensity increased. In the patients with heart
failure, the shortening of PWTT from rest to peak exercise was smaller in
those with lower exercise capacity and those with higher VE-VCO2 slope, an
established index known to reflect the severity of heart failure.