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Please use this identifier to cite or link to this item: http://hdl.handle.net/2440/74569

Type: Journal article
Title: Measurement of central aortic pulse pressure: Noninvasive brachial cuff-based estimation by a transfer function vs. a novel pulse wave analysis method
Author: Cheng, Hao-Min
Sung, Shih-Hsien
Shih, Yuan-Ta
Chuang, Shao-Yuan
Yu, Wen-Chung
Chen, Chen-Huan
Citation: American Journal of Hypertension, 2012; 25(11):1162-1169
Publisher: Elsevier Science Inc
Issue Date: 2012
ISSN: 0895-7061
School/Discipline: The Joanna Briggs Institute
Department: Faculty of Health Sciences
Statement of
Responsibility: 
Hao-Min Cheng, Shih-Hsien Sung, Yuan-Ta Shih, Shao-Yuan Chuang, Wen-Chung Yu and Chen-Huan Chen
Abstract: BACKGROUND The prognostic value of central aortic pulse pressure (PP-C) may have been underestimated due to its measurement inaccuracy. We aimed to investigate the accuracy of noninvasive brachial cuff-based estimation of PP-C by a generalized transfer function (GTF) or a novel pulse wave analysis (PWA) approach to directly estimate PP-C. METHODS Invasive high-fidelity right brachial and central aortic pressure tracings, and left brachial pulse volume plethysmography (PVP) waveforms from an oscillometric blood pressure (BP) monitor were all digitized simultaneously in 40 patients during cardiac catheterization. An aortic-to-brachial GTF and a PWA multivariate prediction model using the PVP waveforms calibrated to brachial cuff systolic BP (SBP) and diastolic BP(DBP) were constructed. Accuracy of the two methods was examined in another 100 patients against invasively measured PP-C. RESULTS The error of cuff PP in estimating PP-C was 1.8 ± 12.4 mm Hg. Application of the GTF on noninvasively calibrated PVP waveforms produced reconstructed aortic pressure waves and PP-C estimates with errors of −3.4 ± 11.6 mm Hg (PP-C = reconstructed aortic SBP − aortic DBP) and −2.3 ± 11.4 mm Hg (PP-C = reconstructed aortic SBP − cuff DBP), respectively. The observed systematic errors were proportional to the magnitudes of PP-C. In contrast, the error of the PWA prediction model was 3.0 ± 7.1 mm Hg without obvious proportional systematic error. CONCLUSIONS Large random and systematic errors are introduced into the PP-C estimates when PP-C is calculated as the difference between the estimated central SBP and central or cuff DBP. The accuracy can be improved substantially with the novel PWA approach.
Keywords: blood pressure; central pulse pressure; hypertension; oscillometric signals; pressure wave reflection; pulse volume plethysmography; pulse wave analysis
Rights: © 2012 American Journal of Hypertension, Ltd.
RMID: 0020122529
DOI: 10.1038/ajh.2012.116
Appears in Collections:Medicine publications
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