This Article Full Text Full Text (PDF) All Versions of this Article: 54/5/1021    most recent HYPERTENSIONAHA.109.137703v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Google Scholar Articles by Papaioannou, T. G. Articles by Stefanadis, C. I. PubMed PubMed Citation Articles by Papaioannou, T. G. Articles by Stefanadis, C. I. Related Collections Pathophysiology Other diagnostic testing

(Hypertension. 2009;54:1021.)
© 2009 American Heart Association, Inc.

Original Articles

Arterial Wave Reflections During the Menstrual Cycle of Healthy Women

A Reproducibility Study

Theodore G. Papaioannou; Kimon S. Stamatelopoulos; George Georgiopoulos; Charalambos Vlachopoulos; Stellios Georgiou; Marita Lykka; Irene Lambrinoudaki; Christos M. Papamichael; Christodoulos I. Stefanadis

From the Biomedical Engineering Unit, 1st Department of Cardiology, Hippokration Hospital (T.G.P., C.V., C.I.S.), and Vascular Laboratory, Department of Clinical Therapeutics, Alexandra Hospital (K.S.S., G.G., S.G., M.L., I.L., C.M.P.), Medical School, National and Kapodistrian University of Athens, Athens, Greece.

Correspondence to Theodore G. Papaioannou, Biomedical Engineering Unit, 1st Department of Cardiology, Hippokration Hospital, 114 Vas. Sophias, Athens 115 28, Greece. E-mail theopap{at}mail.ntua.gr

Increased wave reflection is an independent factor associated with cardiovascular diseases, risk, and mortality. The influence of the menstrual cycle on wave reflections and particularly on the reproducibility of their measurement has never been examined. The aim of the present study was to examine the reproducibility and variability of wave reflection indices in premenopausal healthy women during their menstrual cycle. Thirty-two women were examined at 3 phases of their menstrual cycle: days 1 to 2 (menstrual phase), days 6 to 14 (late follicular), and days 4 to 7 after ovulation (early luteal phase). Applanation tonometry of the radial artery and aortic pulse wave analysis were performed for the calculation of augmentation pressure, augmentation index, and timing of reflected waves. Reproducibility of these measures was evaluated by intraclass correlation coefficient and Bland-Altman analysis, whereas ANOVA was performed to assess their variability during the menstrual cycle. The SD of augmentation index differences between repeated measurements within the menstrual cycle ranged from 7.6% to 9.9%. Bland-Altman analysis indicated no evidence of systemic bias and no trend for the reproducibility of measurements to vary with their underlying mean value. Intraclass correlation coefficient indicated a moderate reproducibility of augmentation index and augmentation pressure (>0.80) and a rather low reproducibility for timing of reflected waves (0.43). Mean augmentation pressure, augmentation index, and timing of reflected waves did not vary significantly during the menstrual cycle (ANOVA). Measurement of wave reflections at the same phase of the menstrual cycle or statistical adjustment could be suggested for optimal study design and data interpretation.

Key Words: applanation tonometry • augmentation index • arterial stiffness • transfer functions • central pressures • menstruation • repeatability