When the large arteries are very stiff, and in
the presence of other cardiovascular
problems, the direct wave and reflected wave
may merge together making it impossible to
distinguish them.
The typical triangular waveform shown on the
adjacent graph is then observed. As no
diastolic inflection point can be found, the message "Stiff" is
displayed.
Sometimes an inflection point can be detected if the measurement is
repeated or sublingual GTN administered, see above. In the over
50s confirmation of stiff conduit arteries may be found in an elevated
pulse-pressure for the subject.
Although the pulse contour analysis algorithm is very robust, the
great variability of physiological waveforms may result in inaccurate
detection of the diastolic inflection point. This occurs in less than 1%
of measurements but it is recommended that a visual quality check
is performed on all waveforms. If the inflection point has been
inaccurately detected in the opinion of the user, the measurement
should be rejected and a new measurement performed.
Effect of exercise
Exercise produces major Haemodynamic changes: increase in heart
rate, change in blood pressure, and profound vasodilation.
Unless exercise is part of your protocol, we advise you to perform
measurements on a relaxed subject.
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