scholarly journals Invasive Validation of Antares, a New Algorithm to Calculate Central Blood Pressure from Oscillometric Upper Arm Pulse Waves

2019 ◽  
Vol 8 (7) ◽  
pp. 1073 ◽  
Author(s):  
Marcus Dörr ◽  
Stefan Richter ◽  
Siegfried Eckert ◽  
Marc-Alexander Ohlow ◽  
Fabian Hammer ◽  
...  
Keyword(s):  
Blood Pressure ◽  
National Standards ◽  
Type Ii ◽  
Non Invasive ◽  
Validation Criteria ◽  
Device Integration ◽  
Pulse Waves ◽  
Aortic Blood Pressure ◽  
Validation Standard ◽  
Central Aortic Blood Pressure

Background: Antares is an algorithm for pulse wave analysis (PWA) by oscillometric blood pressure (BP) monitors in order to estimate central (aortic) blood pressure (cBP). Antares aims to enable brachial cuff-based BP monitors to be type II-devices, determining absolute cBP values independently of potential peripheral BP inaccuracies. The present study is an invasive validation of the Antares algorithm in the custo screen 400. Methods: We followed entirely the 2017 ARTERY protocol for validation of non-invasive cBP devices, the 2013 American National Standards Institute, Inc./Association for the Advancement of Medical Instrumentation/International Organization for Standardization (ANSI/AAMI/ISO) 81060-2 and 2018 AAMI/European Society of Hypertension (ESH)/ISO validation standard protocols. In total, 191 patients undergoing cardiac catheterization were included, of which 145 patients entered analysis. Invasive cBP recordings were compared to simultaneous non-invasive cBP estimations using the Antares algorithm, integrated into an oscillometric BP monitor. Results: Mean difference between invasive and non-invasively estimated systolic cBP was 0.71 mmHg with standard deviation of 5.95 mmHg, fulfilling highest validation criteria. Conclusion: Antares is the first algorithm for estimation of cBP that entirely fulfills the 2017 ARTERY and AAMI/ESH/ISO validation protocols. The Antares algorithm turns the custo screen 400 BP monitor into a type II-device. Integration of Antares into commercially available BP monitors could make it possible to measure PWA parameters in virtually every practice in future.

Estimation of Central Aortic Blood Pressure From Non-Invasive Cuff Pressure Oscillation Signals via System Identification

2016 ◽  
Author(s):  
Zahra Ghasemi ◽  
Chang-Sei Kim ◽  
Eric Ginsberg ◽  
John Duell ◽  
Anuj Gupta ◽  
...  
Keyword(s):  
Blood Pressure ◽  
System Identification ◽  
Cuff Pressure ◽  
Pressure Oscillation ◽  
Pressure Waveform ◽  
Non Invasive ◽  
Aortic Blood ◽  
Blood Pressure Waveform ◽  
Aortic Blood Pressure ◽  
Central Aortic Blood Pressure

This paper presents a model-based system identification approach to estimation of central aortic blood pressure waveform from non-invasive cuff pressure oscillation signals. First, we developed a mathematical model that can reproduce the relationship between central aortic blood pressure waveform and non-invasive cuff pressure oscillation signals at diametric locations by combining models to represent wave propagation in the artery, arterial pressure-volume relationship, and mechanics of the occlusive cuff. Second, we formulated the problem of estimating central aortic blood pressure waveform from non-invasive cuff pressure oscillation signals into a system identification problem. Third, we showed the proof-of-concept of the approach using simulated central aortic blood pressure waveform and cuff pressure oscillation signals. Finally, we illustrated the feasibility of the approach using central aortic blood pressure waveform and cuff pressure oscillation signals collected from a human subject. We showed that the proposed approach could estimate central aortic blood pressure waveform with accuracy: the root-mean-squared error associated with the central aortic blood pressure waveform was 1.7 mmHg (amounting to 1.6 % of the underlying mean blood pressure) while the errors associated with central aortic systolic and pulse pressures were −0.4 mmHg and −1.5 mmHg (amounting to −0.3 % and −1.4 % of the underlying mean blood pressure).

Abstract 16763: Unchanged Central Aortic Blood Pressure and Increased Myocardial Perfusion in Patients With Stable Coronary Artery Disease Receiving Ivabradine

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Bernard I. Levy ◽  
Jean-Guillaume Dillinger ◽  
Patrick Henry ◽  
Damien Logeart ◽  
Stephane Manzo Silberman ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Myocardial Perfusion ◽  
Beta Blocker ◽  
Central Blood Pressure ◽  
Pronounced Increase ◽  
Aortic Blood ◽  
Perfusion Time ◽  
Aortic Blood Pressure ◽  
Central Aortic Blood Pressure

Background: Treatment of hypertensive patients with beta-blockers reduces heart rate (HR) and increases central blood pressure, implying that the decrease in HR could explain reported increases in cardiovascular risk with beta-blocker. This analysis from a randomized, double-blind study explores whether HR reduction with the I f inhibitor ivabradine had an impact on central blood pressure and coronary perfusion. Methods and results: We included 12 normotensive patients with stable CAD, HR ≥70 bpm (sinus rhythm), and stable background beta-blocker therapy. Patients received ivabradine 7.5 mg bid or matched placebo for two 3-week periods with a crossover design and evaluation by aplanation tonometry. Treatment with ivabradine was associated with a significant reduction in resting HR after 3 weeks versus no change with placebo (-15.8±7.7 versus +0.3±5.8 bpm, p=0.0010). There was no relevant between-group difference in change in central aortic SBP (-4.0±9.6 versus +2.4±12.0 mm Hg, p=0.13) or augmentation index (-0.8±10.0% versus +0.3±7.6%, p=0.87). Treatment with ivabradine was associated with prolongation of diastolic perfusion time by 41% from baseline to 3 weeks (+215.6±105.3 versus -3.0±55.8 ms with placebo, p=0.0005) (Figure) and with a pronounced increase in an index of myocardial viability (Buckberg index, +39.3±27.6% versus -2.5±13.5% with placebo, p=0.0015). There were no safety issues during the study. Conclusion: Heart rate reduction with ivabradine does not modify central aortic blood pressure and is associated with a marked prolongation of diastolic perfusion time and an improvement in myocardial perfusion.

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