Ren Yajuan1, Xiao Husheng1, Xu Fang1, Liu Ping2, Wang Yanchun1, Ma Feifei1
1. Department of Ultrasound, Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 200032;
2. Department of Cardiology, Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 200032
Funding Project:
National Natural Science Foundation Youth Fund Project (81503413); Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine Institutional Project (KY2010)
Corresponding Author:
Xu Fang, Email: [email protected].
Keywords: Instant Wave Intensity (WI), Principal Component Analysis (PCA), Orthogonal Partial Least Squares Discriminant Analysis (OPLS-DA), Objective Assessment of TCM Pulse Diagnosis
Abstract: Objective: To apply Instant Wave Intensity (WI) technology to detect parameters of the common carotid artery in patients with early hypertension characterized by a string-like pulse, analyze the pulse characteristics of early hypertension string pulse, extract characteristic parameters for distinguishing string pulse patterns, and explore the characteristics of WI parameters in early hypertension string pulse patients, aiming to provide an objective basis for precise classification and interpretation of string pulse. Methods: A total of 52 cases of early primary hypertension with string pulse, 50 cases of physiological string pulse, and 50 cases of normal pulse were selected to analyze the WI parameters of their common carotid arteries, summarize the pulse characteristics of early hypertension string pulse, and use SIMCA 14.1 statistical software to extract the main parameters for pulse pattern classification. Results: Compared with the normal pulse group and physiological string pulse group, the early hypertension string pulse group showed increased values of Instant Acceleration Wave Intensity (W1) and Negative Area (NA), and a decreased W1-W2 interval (all P < 0.01); however, there were no statistically significant differences in W1, NA, and W1-W2 interval between the normal pulse group and physiological string pulse group (all P > 0.05). The vascular pressure-strain elastic modulus (EP), pulse wave velocity (PWV), and vascular stiffness parameter (β) values gradually increased in the normal pulse group, physiological string pulse group, and early hypertension string pulse group (all P < 0.01). The vascular compliance (AC) of the normal pulse group was higher than that of the other two groups (all P < 0.01), and the physiological string pulse group had a higher AC than the early hypertension string pulse group (P < 0.05). There was no statistically significant difference in R-W1 interval among the three groups (P > 0.05). Based on Principal Component Analysis (PCA) and Orthogonal Partial Least Squares Discriminant Analysis (OPLS-DA), the physiological string pulse group and normal pulse group showed clear sample differentiation, indicating that the differences in WI parameters between the two groups were statistically significant (all P < 0.05), with characteristic WI parameters [Variable Importance in Projection (VIP) > 1] being EP, PWV, β, and AC, with contribution rates of EP > PWV > β > AC. Based on PCA and OPLS-DA, the physiological string pulse group and early hypertension string pulse group also showed clear sample differentiation, indicating that the differences in WI parameters between the two groups were statistically significant (all P < 0.05), with characteristic WI parameters (VIP > 1) being EP, PWV, NA, W1, and β, with contribution rates of EP > PWV > NA > W1 > β. Conclusion: The characteristic WI parameters distinguishing the early hypertension string pulse group from the physiological string pulse group are EP, PWV, β, NA, and W1. The characteristic parameters distinguishing the normal pulse group from the physiological string pulse group are EP, PWV, β, and AC. The WI technology can provide an objective basis for precise classification and interpretation of pulse patterns and is worthy of further promotion and application.
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