Kim Chang-Sei, Fazeli Nima, McMurtry M Sean, Finegan Barry A, Hahn Jin-Oh
IEEE J Biomed Health Inform. 2015 Jan;19(1):309-16. doi: 10.1109/JBHI.2014.2307273.
This paper presents a novel minimally invasive method for quantifying blood pressure (BP) wave reflection in the arterial tree. In this method, two peripheral BP waveforms are analyzed to obtain an estimate of central aortic BP waveform, which is used together with a peripheral BP waveform to compute forward and backward pressure waves. These forward and backward waves are then used to quantify the strength of wave reflection in the arterial tree. Two unique strengths of the proposed method are that 1) it replaces highly invasive central aortic BP and flow waveforms required in many existing methods by less invasive peripheral BP waveforms, and 2) it does not require estimation of characteristic impedance. The feasibility of the proposed method was examined in an experimental swine subject under a wide range of physiologic states and in 13 cardiac surgery patients. In the swine subject, the method was comparable to the reference method based on central aortic BP and flow. In cardiac surgery patients, the method was able to estimate forward and backward pressure waves in the absence of any central aortic waveforms: on the average, the root-mean-squared error between actual versus computed forward and backward pressure waves was less than 5 mmHg, and the error between actual versus computed reflection index was less than 0.03.
本文提出了一种用于量化动脉树中血压(BP)波反射的新型微创方法。在该方法中,分析两个外周血压波形以获得中心主动脉血压波形的估计值,该估计值与一个外周血压波形一起用于计算向前和向后的压力波。然后,这些向前和向后的波用于量化动脉树中波反射的强度。所提出方法的两个独特优势在于:1)它用侵入性较小的外周血压波形取代了许多现有方法中所需的侵入性较大的中心主动脉血压和血流波形;2)它不需要估计特征阻抗。在所提出的方法在广泛的生理状态下的实验猪受试者以及13名心脏手术患者中进行了可行性检验。在猪受试者中,该方法与基于中心主动脉血压和血流的参考方法相当。在心脏手术患者中,该方法能够在没有任何中心主动脉波形的情况下估计向前和向后的压力波:平均而言,实际与计算得到的向前和向后压力波之间的均方根误差小于5 mmHg,实际与计算得到的反射指数之间的误差小于0.03。