1
|
Laloy-Borgna G, Catheline S. [A surprising discovery about the pulse]. Med Sci (Paris) 2023; 39:924-925. [PMID: 38108719 DOI: 10.1051/medsci/2023172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2023] Open
Affiliation(s)
- Gabrielle Laloy-Borgna
- Laboratoire de thérapie et applications ultrasonores, (LabTAU), Inserm, centre Léon Bérard, université Lyon 1, Univ Lyon, Lyon, France
| | - Stefan Catheline
- Laboratoire de thérapie et applications ultrasonores, (LabTAU), Inserm, centre Léon Bérard, université Lyon 1, Univ Lyon, Lyon, France
| |
Collapse
|
2
|
Baranger J, Villemain O, Goudot G, Dizeux A, Le Blay H, Mirault T, Messas E, Pernot M, Tanter M. The fundamental mechanisms of the Korotkoff sounds generation. SCIENCE ADVANCES 2023; 9:eadi4252. [PMID: 37792931 PMCID: PMC10550233 DOI: 10.1126/sciadv.adi4252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 09/05/2023] [Indexed: 10/06/2023]
Abstract
Blood pressure measurement is the most widely performed clinical exam to predict mortality risk. The gold standard for its noninvasive assessment is the auscultatory method, which relies on listening to the so-called "Korotkoff sounds" in a stethoscope placed at the outlet of a pneumatic arm cuff. However, more than a century after their discovery, the origin of these sounds is still debated, which implies a number of clinical limitations. We imaged the Korotkoff sound generation in vivo at thousands of images per second using ultrafast ultrasound. We showed with both experience and theory that Korotkoff sounds are paradoxically not sound waves emerging from the brachial artery but rather shear vibrations conveyed in surrounding tissues by the nonlinear pulse wave propagation. When these shear vibrations reached the stethoscope, they were synchronous, correlated, and comparable in intensity with the Korotkoff sounds. Understanding this mechanism could ultimately improve blood pressure measurement and provide additional understanding of arterial mechanical properties.
Collapse
Affiliation(s)
- Jerome Baranger
- Physics for Medicine Paris, Inserm, ESPCI PSL Paris, CNRS, Paris, France
| | - Olivier Villemain
- Physics for Medicine Paris, Inserm, ESPCI PSL Paris, CNRS, Paris, France
| | - Guillaume Goudot
- Physics for Medicine Paris, Inserm, ESPCI PSL Paris, CNRS, Paris, France
- Université Paris Cité, Inserm UMR 970, PARCC, Vascular Medicine Department, Hôpital Européen Georges-Pompidou, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Alexandre Dizeux
- Physics for Medicine Paris, Inserm, ESPCI PSL Paris, CNRS, Paris, France
| | - Heiva Le Blay
- Physics for Medicine Paris, Inserm, ESPCI PSL Paris, CNRS, Paris, France
| | - Tristan Mirault
- Université Paris Cité, Inserm UMR 970, PARCC, Vascular Medicine Department, Hôpital Européen Georges-Pompidou, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Emmanuel Messas
- Université Paris Cité, Inserm UMR 970, PARCC, Vascular Medicine Department, Hôpital Européen Georges-Pompidou, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Mathieu Pernot
- Physics for Medicine Paris, Inserm, ESPCI PSL Paris, CNRS, Paris, France
| | - Mickael Tanter
- Physics for Medicine Paris, Inserm, ESPCI PSL Paris, CNRS, Paris, France
| |
Collapse
|