Changes of radial artery pulse wave in patients with newly diagnosed chronic disease before and after a single precisely individualized exercise

Objective To observe and investigate the resting radial artery pulse wave and its changes after a single precisely individualized exercise in patients with newly diagnosed chronic disease. Methods Sixteen patients with newly diagnosed chronic disease（mainly including hypertension, hyperlipidaemia and diabetes） before starting treatment were recruited and completed a single individualized exercise with exercise intensity specified via the cardiopulmonary exercise testing. Radial artery pulse wave within consecutive 50 s were recorded before and 10, 20, 30 min after exercise respectively, and the following indicators were analyzed and compared: the relative amplitude of the peak point（P1） of the main wave(ΔY_P1), the relative amplitude of the valley point（PL） of the dicrotic wave(ΔY_PL), the relative amplitude of the peak point P2 of the dicrotic wave(ΔY_P2), the time of T_PL（contraction period）, the time of pulse wave end point（T_E）（cardiac cycle）, T_E-T_PL（diastolic period）, pulse rate, ascending branch slope of main wave（S₁）, ascending branch slope of dicrotic wave（S₂）, the amplitude of dicrotic wave(ΔY_P2-ΔY_PL), the time of dicrotic wave(T_P2-T_PL) and the occurrence rate of dicrotic wave with obvious crest. Meanwhile, the data was compared with the data of 16 healthy young people, 16 healthy middle-aged to elderly people and 16 patients with long-term chronic diseases. Results At rest state, ΔY_P1, ΔY_P2, S₁, S₂, ΔY_P2-ΔY_PL, T_P2-T_PL in patients with newly diagnosed chronic disease were smaller than those of healthy young people, but the pulse rate was larger（all P＜0.05）. ΔY_P1, ΔY_PL were larger than those of healthy middle-aged to elderly people, but T_P2-T_PL was smaller（all P＜0.05）. Furthermore, ΔY_P2-ΔY_PL was larger（P＜0.05） than those of patients with long-term chronic diseases. During rest state, the occurrence of dicrotic waves with obvious peaks in patients with newly diagnosed chronic disease was smaller than those of healthy young people and healthy middle-aged to elderly people, but larger than those of patients with long-term chronic disease（52.07% vs 94.48% vs 73.32% vs 28.65%, χ~2=876.120, P＜0.001）. Ten minutes after exercise, T_E, T_E-T_PL and ΔY_PL in patients with newly diagnosed chronic disease were decreased, while pulse rate, T_P2-T_PL and the occurrence of dicrotic waves with obvious peaks were increased（all P＜0.05）. Compared with healthy young people, ΔY_PL was larger, and the occurrence of dicrotic waves with obvious peaks was smaller（both P＜0.05）. Compared with healthy middle-aged to elderly people, pulse rate was larger, T_E-T_PL and the occurrence of dicrotic waves with obvious peaks were smaller（all P＜0.05）. While ΔY_P1, T_E, T_E-T_PL were lower than those of patients with long-term chronic disease, and the pulse rate, occurrence of dicrotic waves with obvious peaks were larger（all P＜0.05）. The variation trend of pulse wave at 20 and 30 min after exercise was consistent with that at 10 min after exercise. Conclusions The radial pulse wave of patients with newly diagnosed chronic disease mainly presents as flat and unclear, or even disappeared dicrotic wave, and the duration of a single pulse wave is shortened. A single precisely individualized exercise can deepen, widen and signalize the dicrotic wave, indicating that the changes of pulse wave, especially the dicrotic wave, can play prewarning role in the occurrence and development of chronic diseases, and preliminarily predict the effect of strengthening exercise control on the treatment of chronic diseases.