Heart-carotid pulse-wave velocity via laser-Doppler vibrometry as a biomarker for arterial stiffening: a feasibility study.

Abstract

Objective. Large artery stiffening leads to an increase in cardiovascular risk and organ damage of the kidneys, brain or the heart. Biomarkers that allow for early detection of this phenomenon are a point of interest in research, with pulse-wave velocity (PWV) having been proven useful in predicting and monitoring arterial stiffness. We previously introduced a laser Doppler vibrometry (LDV) prototype which can measure carotid-femoral PWV (cfPWV). In this work, we assess the feasibility of using the same device to infer heart-carotid pulse-transit time (hcPTT) as a first step towards measuring heart-carotid PWV (hcPWV). The advantage of hcPWV over cfPWV is that the ascending aorta, which is the most distensible segment of the aorta contributing most to total arterial compliance, is included in the arterial pathway.Approach. Signals were simultaneously acquired from a location on the chest (near either the base or the apex of the heart) and the right carotid artery for 100 patients (45% female). Fiducial points on the heart waveforms are associated with opening and closure (second heart sound; S2) of the aortic valve, which can be combined with, respectively, the foot and dicrotic notch (DN) of the carotid waveform to retrieve hcPTT. Considering two distinct heart-signal measurement sites, four hcPTT estimations are evaluated in about 94% of all measurements.Main results. Correlations between these and known predictors of arterial stiffness i.e. age, blood pressure and carotid-femoral PTT via applanation tonometry indicated that combining S2 from a heart-measurement site located at the base of the heart, with the carotid DN yields hcPTT providing convincing correlations with known determinants of arterial stiffness (ρ = 0.377 with age).Significance.We conclude that LDV may provide a corollary biomarker of arterial stiffness, encompassing the ascending aorta.