Wrist Pulse Study

Professor Allen T. ChwangSir Robert Ho Tung Chair

The University of Hong Kong

Mortality Statistics by Disease Group 2000

3891

48

21

2

749

108

7865

784

152

2073

627

594

18069

0 2000 4000 6000 8000 10000 12000 14000 16000 18000 20000

Respiratory disease

Skin disesases

Sense organ diseases

Oral conditions

Neuro-psychiatric conditions

Other neoplasms

Malignant neoplasms

Genito-urinary diseases

Endocrine disorders

Digestive diseases

Diabetes mellitus

Congenital anomalies

Cardiovascular diseases

Mortality Rate x1000

Source: World Health Statistics

No. 1

Traditional Chinese Medicine

• A healthy body is maintained by• the interaction between Yin and Yang

• the balance of the five elements:- Gold, Wood, Water, Fire, Earth

• The theories of pulse diagnosis are holistic and experience based

• The fingers of physicians are the pulse sensors

The Three Common Positionsfor Chinese Pulse Diagnosis

Cun Guan Chi

The Twenty-seven Pulse-states

• Floating• Hollow• Scattered• Sinking• Hidden• Slow• Rapid• Flooding• Thin

• Weak• Minute• Full• Empty• Slippery• Leisurely • Moving• Choppy• Wiry

• Tight• Leather• Firm• Soft• Knotted• Intermittent• Hasty• Long• Short

The Wrist-Pulse Sensing Device

0 500 1000 1500 2000 25000.25

0.3

0.35

0.4

0.45

0.5

0.55

0.6V

olta

ge,V

Points,x

Cun GuanChi

The Cun, Guan and Chi Wrist Pulses

Legend: P-wave : Percussion wave; T-wave : Tidal wave; V : Valley; D-wave : Diastolic wave;

A Typical Wrist Pulse

P-wave

T-wave

D-wave

V

Systole

Aortic valve and pulmonary valve opening

Aortic valve and pulmonary valve closure

Diastole

Bicuspid valve and tricuspid valve opening

Bicuspid valve and tricuspid valve closure

Identification of Wrist Pulse PropertiesWrist Pulse

S-pattern

Normal Group

• 123 subjects (57 M & 66 F) are studied

• All subjects are free of chest pain and have no history of cardiovascular disease, diabetes mellitus and excessive alcohol use

• The Normal group is subdivided into N20-39, N40-49 and N50 groups

Normal Group

Normal Group

Normal Group

Normal Group

• The elasticity of arteries tends to decrease with advancing age

• The resistance of the peripheral arteries increases

• The rate of wave reflection from the peripheral arteries increases and makes a rise in the arterial blood pressure at an earlier stage of a cardiac cycle

• The wrist-pulse classifications quantitatively display an age-related trend of hemodynamic properties in healthy subjects

Hypertension (HT) Group

• 25 patients (10 M & 15 F aged 6110) with essential hypertension either treated or untreated are studied

• Mean systolic blood pressure 162 20 mmHg

• Mean diastolic blood pressure 83 12 mmHg

• Normal ECG

• No history of cardiovascular disease

• Age and heart rate matched with the N50 group

Hypertension (HT) Group

Hypertension (HT) Group

• Hypertension causes changes in the arterial structures

• Wave reflection rate increases greatly in hypertensive subjects, which causes a disproportionate increase in the arterial blood pressure during the cyclic ventricular ejection phase

• The wrist-pulse analysis shows that the hypertensive subjects have a faster rate of wave reflection than the normotensive subjects

Coronary Artery Disease Group

• 60 patients (47 M & 13 F aged 64 9) with documented coronary artery disease are studied

• The patients are subdivided into the CADHT and the CAD groups

• Age matched with the N50 and the HT groups

Coronary Artery Disease Group

Coronary Artery Disease Group

Coronary Artery Disease Group

• The wrist pulses of both the CADHT and the CAD groups have steeper systolic slopes than those of the N50 and the HT groups

• Coronary artery disease would alter the whole cycle of hemodynamic properties

The Innovation and Technology Fund

Funding: HKD 3,276,000

Duration: April 1, 2002 – March 31, 2004

Objectives:

• To design and construct a non-invasive wrist-pulse sensor

• To establish a relationship between wrist pulses and cardiovascular conditions

Team members: Dr. Elizabeth OY Lau; Prof. CP Lau; Dr. HW Chan; Dr. HF Tse

Thank you