scholarly journals How Effective Is Pulse Arrival Time for Evaluating Blood Pressure? Challenges and Recommendations from a Study Using the MIMIC Database

2019 ◽  
Vol 8 (3) ◽  
pp. 337 ◽  
Author(s):  
Yongbo Liang ◽  
Derek Abbott ◽  
Newton Howard ◽  
Kenneth Lim ◽  
Rabab Ward ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Arrival Time ◽  
Medical Information ◽  
Pulse Wave ◽  
The Body ◽  
Time Interval ◽  
Pulse Arrival Time ◽  
Detection Techniques ◽  
And Control ◽  
Pulse Arrival

Cardiovascular disease (CVD) is the number one cause of non-infectious morbidity and mortality in the world. The detection, measurement, and management of high blood pressure play an essential role in the prevention and control of CVDs. However, owing to the limitations and discomfort of traditional blood pressure (BP) detection techniques, many new cuff-less blood pressure approaches have been proposed and explored. Most of these involve arterial wave propagation theory, which is based on pulse arrival time (PAT), the time interval needed for a pulse wave to travel from the heart to some distal place on the body, such as the finger or earlobe. For this study, the Medical Information Mart for Intensive Care (MIMIC) database was used as a benchmark for PAT analysis. Many researchers who use the MIMIC database make the erroneous assumption that all the signals are synchronized. Therefore, we decided to investigate the calculation of PAT intervals in the MIMIC database and check its usefulness for evaluating BP. Our findings have important implications for the future use of the MIMIC database, especially for BP evaluation.

scholarly journals Interrelationships between pulse arrival time and arterial blood pressure during postural transitions before and after spaceflight

2019 ◽  
Vol 127 (4) ◽  
pp. 1050-1057
Author(s):  
Katelyn N. Wood ◽  
Danielle K. Greaves ◽  
Richard L. Hughson
Keyword(s):  
Blood Pressure ◽  
Arterial Blood Pressure ◽  
Arrival Time ◽  
Standing Posture ◽  
Pulse Arrival Time ◽  
Arterial Blood ◽  
Increased Risk ◽  
Before And After ◽  
Acute Changes ◽  
Pulse Arrival

We tested the hypothesis that acute changes in arterial blood pressure (BP) when astronauts moved between supine and standing posture before and after spaceflight can be tracked by beat-to-beat changes in pulse arrival time (PAT). Nine male crewmembers (45 ± 7 yr of age; mean mission length: 165 ± 13 days) participated in a standardized supine-to-sit-to-stand test (5 min-30 s-3 min) before flight and 1 day following return to Earth with continuous monitoring of ECG and finger arterial BP. PAT was determined from the R-wave of the ECG to the foot of the BP waveform. On average, modest cardiovascular deconditioning was detected by ~10 beats/min increase in heart rate in supine and standing posture after spaceflight ( P < 0.05). When looking across the full data collection period, the r2 values between inverse of PAT (1/PAT) and systolic (SBP) and diastolic BP (DBP) varied considerably between individuals (SBP preflight 0.142 ± 0.186, postflight 0.262 ± 0.243). Individual variability was consistent during periods of transition (SBP preflight 0.284 ± 0.324, postflight 0.297 ± 0.269); however, when SBP dropped >20 mmHg, r2 was significant in 5 of 5 preflight tests and 5 of 7 postflight tests. The standard error of the estimate based on a simple linear model during both pre- and postflight testing was 9–11 mmHg for SBP and 6–7 mmHg for DBP. Overall, the results support the hypothesis that PAT tracked dynamic changes in BP. PAT as a noninvasive, nonintrusive surrogate for changes in BP could be developed as an indicator of risk for syncope on return from spaceflight or other Earth-based applications. NEW & NOTEWORTHY Astronauts returning to Earth’s gravity are at increased risk of low blood pressure on standing. Arterial pulse arrival time tracked the decrease in arterial blood pressure on moving from supine to upright posture. Nonintrusive technology providing indicators sensitive to acute changes in blood pressure could act as an early warning system to identify risk for hypotension that place astronauts, or people on Earth, at risk of impaired cognitive performance, fainting, and falls.

scholarly journals Real-Time Monitoring of Blood Pressure Using Digitalized Pulse Arrival Time Calculation Technology for Prompt Detection of Sudden Hypertensive Episodes During Laryngeal Microsurgery: Retrospective Observational Study (Preprint)

2018 ◽  
Author(s):  
Yong-Seok Park ◽  
Sung-Hoon Kim ◽  
Yoon Se Lee ◽  
Seung-Ho Choi ◽  
Seung-Woo Ku ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Arrival Time ◽  
Characteristic Curve ◽  
Sudden Change ◽  
Area Under The Curve ◽  
Sudden Increase ◽  
Maximum Slope ◽  
Pulse Arrival Time ◽  
Before And After ◽  
Pulse Arrival

BACKGROUND Laryngeal microsurgery (LMS) is often accompanied by a sudden increase in blood pressure (BP) during surgery because of stimulation around the larynx. This sudden change in the hemodynamic status is not immediately reflected in a casual cuff-type measurement that takes intermittent readings every 3 to 5 min. OBJECTIVE This study aimed to investigate the potential of pulse arrival time (PAT) as a marker for a BP surge, which usually occurs in patients undergoing LMS. METHODS Intermittent measurements of BP and electrocardiogram (ECG) and photoplethysmogram (PPG) signals were recorded during LMS. PAT was defined as the interval between the R-peak on the ECG and the maximum slope on the PPG. Mean PAT values before and after BP increase were compared. PPG-related parameters and the correlations between changes in these variables were calculated. RESULTS BP surged because of laryngoscopic manipulation (mean systolic BP [SBP] from 115.3, SD 21.4 mmHg, to 159.9, SD 25.2 mmHg; <i>P</i>&lt;.001), whereas PAT decreased significantly (from mean 460.6, SD 51.9 ms, to 405.8, SD 50.1 ms; <i>P</i>&lt;.001) in most of the cases. The change in SBP showed a significant correlation with the inverse of the PAT (<i>r</i>=0.582; <i>P</i>&lt;.001). Receiver-operating characteristic curve analysis indicated that an increase of 11.5% in the inverse of the PAT could detect a 40% increase in SBP, and the area under the curve was 0.814. CONCLUSIONS During LMS, where invasive arterial catheterization is not always possible, PAT shows good correlation with SBP and may, therefore, have the potential to identify abrupt BP surges during laryngoscopic manipulations in a noninvasive manner. CLINICALTRIAL

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