Association between cardiovascular parameters of pulse wave analysis and Qi deficiency and blood stasis syndromes

Objective: Qi Deficiency (QD), Blood Stasis (BS) and Qi Deficiency and Blood Stasis (QDBS) syndromes are diagnosed in traditional Chinese medicine through palpation of the pulse, observation of tongue and colour of the face, and patient feedback on questions regarding areas such as pain, lassitude, dysmenorrhea, numbness, roughness of skin and nails, and propensity to sweat. The syndromes are viewed as being related to cardiovascular factors; QD is believed to compromise the efficiency of the circulatory system and BS is believed to be associated with reduced perfusion. This pilot study investigated if these syndromes are associated with conventional cardiovascular parameters obtained from pulse wave analysis of brachial and aortic blood pressure. Design and Method: From a cohort of 36 subjects (46 ± 18 years, 18 female), a qualified traditional Chinese Medicine doctor diagnosed 13 subjects with QD and 15 subjects with BS. Within these, 9 subjects had both QD and BS. Brachial blood pressure and derived aortic blood pressure (SphygmoCor Xcel, AtCor Medical) was obtained in all subjects in the seated position; carotid-femoral pulse wave velocity (cfPWV) was measured in the supine position. Pulse wave analysis was performed for all blood pressure waveforms. For this pilot study, p = 0.1 was deemed to designate parameters potentially worthy of further study. Results: The sample size was not sufficiently powered for assessing significance in stepwise multiple linear regression, though there was a trend toward syndromes being more likely to be present in older subjects. A subset of QD (n = 6), BS (n = 9) and QDBS (n = 6) were compared to age and gender matched control subjects. There was no significant difference in any pulse wave analysis parameters between controls and QD. Brachial systolic pressure (BS: 134 ± 28, control: 123 ± 11 mm Hg, p = 0.08), brachial and aortic mean pressure (BS: 98 ± 11, control: 91 ± 10 mm Hg, p = 0.04), and aortic diastolic pressure (BS: 80 ± 8, control: 75 ± 12 mm Hg, p = 0.09) were different (at p = 0.1) between controls and BS. Aortic mean pressure was higher in QDBS subjects than controls (QDBS:99 ± 11, control: 90 ± 13 mm Hg, p = 0.07). Across all syndromes, there was no trend toward higher cfPWV or aortic augmentation index or changes in ejection duration, features often reported in the Chinese journal literature