Central Blood Pressure: Part 2, Pulse Wave Analysis

Pulse Waves ◽  
2016 ◽  
pp. 109-173
Author(s):  
Paolo Salvi
Keyword(s):  
Blood Pressure ◽  
Pulse Wave ◽  
Pulse Wave Analysis ◽  
Central Blood Pressure ◽  
Wave Analysis ◽  
Pressure Part

Automated non-invasive central blood pressure measurements by oscillometric radial pulse wave analysis – results of the MEASURE-cBP validation studies

2020 ◽  
Author(s):  
Frederik Trinkmann ◽  
Urs Benck ◽  
Julian Halder ◽  
Alexandra Semmelweis ◽  
Joachim Saur ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Pulse Wave ◽  
Applanation Tonometry ◽  
Pulse Wave Analysis ◽  
Central Blood Pressure ◽  
Diabetic Patients ◽  
Radial Pulse ◽  
Wave Analysis ◽  
Operator Training ◽  
Non Invasive

Abstract Background Central blood pressure becomes increasingly accepted as an important diagnostic and therapeutic parameter in the management of cardiovascular disease. This led to development of several non-invasive techniques most commonly based on peripheral pulse wave analysis. Accuracy of widespread applanation tonometry can be affected by calibration and operator training. To overcome this, we aimed to evaluate a novel device (VascAssist 2) using automated oscillometric radial pulse wave analysis and a refined multi-compartment model of the arterial tree. Methods 225 patients were prospectively enrolled. Invasive aortic root measurements served as reference in MEASURE-cBP 1 (n=106) whereas an applanation tonometry device (SphygmoCor) was used in MEASURE-cBP 2 (n=119). Results In MEASURE-cBP 1, we found a mean overestimation for systolic values of 4±12 mmHg (3±10%) and 6±10 mmHg (9±14%) for diastolic values. Diabetes mellitus and low blood pressure were associated with larger variation. In MEASURE-cBP 2, mean overestimation of systolic values was 4±4 mmHg (4±4%) and 1±4 mmHg (1±7%) of diastolic values. Arrhythmia was significantly more frequent in invalid measurements (61 vs. 18%, p<0.0001) which were most often due to a low quality index of SphygmoCor. Accuracy did not differ between patients with arrhythmia and sinus rhythm in MEASURE-cBP 1. Conclusions Central blood pressure estimates using VascAssist 2 can be considered at least as accurate as available techniques, even including diabetic patients. In direct comparison, automated measurement considerably facilitates application not requiring operator training and can be reliably applied even in patients with arrhythmias.

Abstract 265: Validation of a novel Brachial Pulse Wave Analysis-Based Method for Estimating Central Blood Pressure among Japanese Cardiovascular Patients

Hypertension ◽  
2014 ◽  
Vol 64 (suppl_1) ◽  
Author(s):  
Toshihiro Shoji ◽  
Sho Okada ◽  
Atsushi Nakagomi ◽  
Yoshio Kobayashi
Keyword(s):  
Blood Pressure ◽  
Gender Difference ◽  
Linear Correlation ◽  
Pulse Wave ◽  
Pearson Correlation ◽  
Japanese Patients ◽  
Pulse Wave Analysis ◽  
Central Blood Pressure ◽  
Wave Analysis ◽  
The Difference

Background: Hypertension is a significant predictive factor for future cardiovascular(CV) events. Historically its assessment has been made at the brachial arm, and this method is still cardinal for hypertension treatment. Blood pressure measured at the root of the aorta, named ‘central’ blood pressure (cBP), shows actual load on the heart and proximal large arteries. It has been recognized as more accurate predictor for CV events than ‘brachial’ one. Despite this, invasive maneuvers on cBP measurement have long limited its widespread clinical use. Recently several non-invasive methods were developed for cBP measurement. ARC Solver algorithm, which calculates cBP from brachial BP using novel pulse wave analysis-based method, enabled us to assess ambulatory cBP values. Though it was already validated among western countries, its accuracy nor optimal conditions still remains unknown among us Japanese. Object: To validate ARC Solver algorithm-based cBP measurement among Japanese CV patients. Method: For 89 patients who underwent elective coronary angiography in our hospital, we simultaneously measured invasive cBP (cBPinv) and calculated cBP with ARC Solver algorithm (cBPcalc) . We used systolic and diastolic BP (Calc1) or mean and diastolic BP(Calc2) for calibration. Then we evaluated the error and correlation of the data with Bland-Altman analysis and Pearson correlation analysis, respectively. After excluding the perturbing factors such as arrhythmia and valvular heart disease, we performed the same analyses. Results: cBPinv and cBPcalc showed good linear correlation (Cal1: r=0.72, p<0.01, Cal2: r=0.748, p<0.01), whereas error between them showed marked difference (Cal1: 17.7±16.3mmHg, Cal2: -7.5mmHg±18.1mmHg). After excluding perturbing factors, the difference even enlarged (Cal1: 19.9±17.0mmHg, Cal2: -3.9±15.5mmHg), although linear correlation was each improved (Cal1: r=0.76, p<0.05, Cal2: r=0.84, p<0.01). Gender difference influenced the error. Conclusions: Mode of calibration significantly influences the calculated cBP with ARC Solver algorithm among Japanese patients with CV diseases. Consideration for the perturbing clinical factors and gender difference are also essential for its proper clinical application.

scholarly journals Pulse Wave Analysis Is a Reproducible Technique for Measuring Central Blood Pressure During Hemodynamic Perturbations Induced by Exercise

2008 ◽  
Vol 21 (10) ◽  
pp. 1100-1106 ◽  
Author(s):  
D. J. Holland ◽  
J. W. Sacre ◽  
S. J. McFarlane ◽  
J. S. Coombes ◽  
J. E. Sharman
Keyword(s):  
Blood Pressure ◽  
Pulse Wave ◽  
Pulse Wave Analysis ◽  
Central Blood Pressure ◽  
Wave Analysis ◽  
Reproducible Technique

scholarly journals Central blood pressure assessment using 24-hour brachial pulse wave analysis

2014 ◽  
pp. 141 ◽  
Author(s):  
Maria Lorenza Muiesan ◽  
Massimo Salvetti ◽  
Anna Paini ◽  
Claudia Agabiti-Rosei ◽  
Fabio Bertacchini ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Pulse Wave ◽  
Pulse Wave Analysis ◽  
Central Blood Pressure ◽  
Wave Analysis

scholarly journals Associations between Intrinsic Heart Rate, P Wave and QT Interval Durations and Pulse Wave Analysis in Patients with Hypertension and High Normal Blood Pressure

2020 ◽  
Vol 17 (12) ◽  
pp. 4350
Author(s):  
Ioana Mozos ◽  
Cristina Gug ◽  
Costin Mozos ◽  
Dana Stoian ◽  
Marius Pricop ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Qt Interval ◽  
Pulse Wave ◽  
Pulse Wave Analysis ◽  
P Wave ◽  
Normal Blood Pressure ◽  
Wave Analysis ◽  
Wave Duration ◽  
P Wave Duration

The present study aimed to explore the relationship between electrocardiographic (ECG) and pulse wave analysis variables in patients with hypertension (HT) and high normal blood pressure (HNBP). A total of 56 consecutive, middle-aged hypertensive and HNBP patients underwent pulse wave analysis and standard 12-lead ECG. Pulse wave velocity (PWV), heart rate, intrinsic heart rate (IHR), P wave and QT interval durations were as follows: 7.26 ± 0.69 m/s, 69 ± 11 beats/minute, 91 ± 3 beats/minute, 105 ± 22 mm and 409 ± 64 mm, respectively. Significant correlations were obtained between PWV and IHR and P wave duration, respectively, between early vascular aging (EVA) and P wave and QT interval durations, respectively. Linear regression analysis revealed significant associations between ECG and pulse wave analysis variables but multiple regression analysis revealed only IHR as an independent predictor of PWV, even after adjusting for blood pressure variables and therapy. Receiver-operating characteristic (ROC) curve analysis revealed P wave duration (area under curve (AUC) = 0.731; 95% CI: 0.569–0.893) as a predictor of pathological PWV, and P wave and QT interval durations were found as sensitive and specific predictors of EVA. ECG provides information about PWV and EVA in patients with HT and HNBP. IHR and P wave durations are independent predictors of PWV, and P wave and QT interval may predict EVA.

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