Abstract
Using a combined 8 MHz pulse-echo and a 9.5 MHz continuous wave-transcutaneous Doppler system, a technique was developed to quantitate brachial artery peak velocity noninvasively. The Parks Model 806 Doppler velocity meter was shown to have a linear output which was accurate to velocities of up to 70 cms[-1] on a steady flow rig and on a pulsatile rig to have a linear frequency response to approximately 9 Hz. Brachial artery peak velocity measurements were obtained from 93 control subjects, (33 male, 60 female) and 58 unselected patients (44 male, 14 female) admitted to the Intensive Therapy Unit of St George's Hospital with chest pain. In all subjects, record was made of age, blood pressure, heart rate, weight, and forearm skin temperature. In the patient group the clinical condition was assessed by a physician using the Peel's Coronary Prognostic Index. There was a highly significant difference (P < 0. 001) between mean peak velocity results in male (x 35.2 cms[-1]) and female (x 29.3 cms[-1]) control subjects. There was no such significant difference (P > 0.05) between the mean peak velocity in the male (x 24.9 cms[-1]) and female (x 27.5 cms[-1]) patients. There was a highly significant difference (P < 0.001) between mean peak velocities in the male control and male patient groups. No such significant difference (P > 0. 05) was observed between the female groups. Eight (14%) of patient group died, 5 males and 3 females. In the male group there was a highly significant difference (P < 0.001) in mean peak velocity between patients who died (x 15.2 cms) and those who survived (x 26.2 cms). No such significant difference (P > 0.05) was observed between mean peak velocity of female patients who died (x 20.5 cms) and survived (x 29.5 cms). It is suggested that brachial artery peak velocity may be of value to the physician as an index of cardiovascular performance in the clinical assessment and management of patients with ischaemic heart disease.