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      The Pilot Study of Evaluating Fluctuation in the Blood Flow Volume of the Radial Artery, a Site for Traditional Pulse Diagnosis


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          Background: Radial artery (RA) pulse diagnosis has been used in traditional Asian medicine. Blood pressure (BP) and pulse rate related to heart rate variability (HRV) can be monitored via the RA. The fluctuation in these parameters has been assessed using fast Fourier transform (FFT) analytical methods that calculate power spectra. Methods: We measured blood flow volume (Volume) in the RA and evaluated its fluctuations. Normal participants ( n = 34) were enrolled. We measured the hemodynamics of the right RA for approximately 50 s using ultrasonography. Results: The parameters showed the center frequency (CF) of the power spectrum at low frequency (LF) and high frequency (HF). More than one spectral component indicated that there were fluctuations. The CF at LF for Volume was significantly different from that for vessel diameter (VD); however, it was significantly correlated with blood flow velocity (Velocity). On the other hand, the CF at HF for Volume was significantly different from that for Velocity; however, it was significantly correlated with VD. Conclusion: It is suggested that fluctuation in the Volume at LF of RA is influenced by the fluctuation in Velocity; on the other hand, fluctuation in the Volume at HF is influenced by the fluctuation in VD.

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          Power spectrum analysis of heart rate variability to assess the changes in sympathovagal balance during graded orthostatic tilt.

          The powers of the low-frequency (LF) and high-frequency (HF) oscillations characterizing heart rate variability (HRV) appear to reflect, in their reciprocal relationship, changes in the state of the sympathovagal balance occurring during numerous physiological and pathophysiological conditions. However, no adequate information is available on the quantitative resolution of this methodology. We studied 22 healthy volunteers (median age, 46.5 years) who were subjected after a rest period to a series of passive head-up tilt steps randomly chosen from the following angles: 15 degrees, 30 degrees, 45 degrees, 60 degrees, and 90 degrees. From the continuous ECG, after appropriate analog-to-digital conversion, a personal computer was used to compute, with an autoregressive methodology, time and frequency domain indexes of RR interval variability. Spectral and cross-spectral analysis with the simultaneously recorded respiratory signal excluded its contribution to LF. Age was significantly correlated to variance and to the absolute values in milliseconds squared of very-low-frequency (VLF), LF, and HF components. The tilt angle was correlated to both LF and HF (expressed in normalized units [nu]) and to the LF-to-HF ratio (r = .78, -.72, and .68; respectively). Lower levels of correlation were found with HF (in ms2) and RR interval. No correlation was present between tilt angle and variance, VLF, or LF (in ms2). Individual analysis confirmed that the use of nu provided the greatest consistency of results. Spectral analysis of HRV, using nu or LF-to-HF ratio, appears to be capable of providing a noninvasive quantitative evaluation of graded changes in the state of the sympathovagal balance.
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            Respiratory sinus arrhythmia in humans: how breathing pattern modulates heart rate.

            The relationship of respiratory sinus arrhythmia amplitude (RSA) to tidal volume and breathing frequency was quantified during voluntarily controlled tidal volume and breathing frequency and spontaneous quiet breathing. Seventeen seated subjects breathed via mouthpiece and nose-clip, maintaining constant tidal volumes at each of several breathing frequencies. Inspiratory breath hold was zero frequency. Log RSA was plotted vs. log frequency for each tidal volume. The large stable RSA for frequencies less than 6 cycles/min was called low-frequency intercept (LFI, 20 +/- 5 beats/min). Low-frequency intercept was inversely proportional to a subject's age only to 35 yr. At higher breathing frequencies above a characteristic corner frequency (fC, 7.2 +/- 1.5 cycles/min) RSA decreased with constant slope (roll-off; 21 +/- 3.4 dB/decade). The RSA-volume relationship was linear permitting normalization of RSA-frequency curves for tidal volume to yield one curve. Spontaneous breathing data points fell on this curve. Voluntarily coupling of heart rate to breathing frequency in integer ratios reduced breath-by-breath variability of RSA without changing mean RSA. In conclusion, low-frequency intercept, corner frequency, and roll-off characterize an individual's RSA-frequency relationship during both voluntarily controlled and spontaneous breathing.
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              Assessment of autonomic function in humans by heart rate spectral analysis.

              Spectral analysis of spontaneous heart rate fluctuations were assessed by use of autonomic blocking agents and changes in posture. Low-frequency fluctuations (below 0.12 Hz) in the supine position are mediated entirely by the parasympathetic nervous system. On standing, the low-frequency fluctuations increase and are jointly mediated by the sympathetic and parasympathetic nervous systems. High-frequency fluctuations, at the respiratory frequency, are decreased by standing and are mediated solely by the parasympathetic system. Heart rate spectral analysis is a powerful noninvasive tool for quantifying autonomic nervous system activity.

                Author and article information

                Role: Academic Editor
                Medicines (Basel)
                Medicines (Basel)
                17 May 2016
                June 2016
                : 3
                : 2
                : 11
                [1 ]Department of Education and Support for Regional Medicine, Department of Kampo Medicine, Tohoku University Hospital, 1-1 Seiryou-machi, Aoba-ku, Sendai, Miyagi 980-8574, Japan; egao.2008@ 123456wine.ocn.ne.jp (M.W.); souichi0134@ 123456gmail.com (S.K.); numatatakehiro@ 123456gmail.com (T.N.); natsu.beauty.summer@ 123456gmail.com (N.S.); t-ishi23@ 123456green.ocn.ne.jp (T.I.)
                [2 ]Comprehensive Education Center for Community Medicine, Graduate School of Medicine, Tohoku University, 2-1 Seiryou-machi, Aoba-ku, Sendai, Miyagi 980-8575, Japan
                [3 ]Institute of Development, Aging and Cancer, Tohoku University, 4-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575, Japan; shiraishi@ 123456idac.tohoku.ac.jp (Y.S.); konnos@ 123456idac.tohoku.ac.jp (S.K.); yambe@ 123456idac.tohoku.ac.jp (T.Y.)
                [4 ]Division of Cyclotron Nuclear Medicine, Cyclotron and Radioisotope Center, Tohoku University, 6-3 Aoba, Aramaki, Aoba-ku, Sendai, Miyagi 980-8578, Japan; tseki.tohoku@ 123456gmail.com
                [5 ]Department of Management Science and Technology, Graduate School of Engineering, Tohoku University, 6-6-05 Aramaki Aza Aoba, Aoba-ku, Sendai, Miyagi 980-8579, Japan; sugita@ 123456yoshizawa.ecei.tohoku.ac.jp
                [6 ]Research Division on Advanced Information Technology, Cyberscience Center, Tohoku University, 6-3 Aramaki Aza Aoba, Aoba-ku, Sendai, Miyagi 980-8578, Japan; yoshizawa@ 123456yoshizawa.ecei.tohoku.ac.jp
                [7 ]Department of Obstetrics and Gynecology, Graduate School of Medicine, Tohoku University, 1-1 Seiryou-machi, Aoba-ku, Sendai, Miyagi 980-8574, Japan; yaegashi@ 123456med.tohoku.ac.jp
                Author notes
                [* ]Correspondence: takayama@ 123456med.tohoku.ac.jp ; Tel.: +81-22-717-7185; Fax: +81-22-717-7186
                © 2016 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                : 24 January 2016
                : 14 April 2016

                pulse diagnosis,radial artery,blood flow volume,fluctuation,ultrasonography


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