Bia Daniel, Salazar Federico, Cinca Luis, Gutierrez Marcos, Facta Alvaro, Zócalo Yanina, Diaz Alejandro
Departamento de Fisiología, Centro Universitario de Investigación, Innovación y Diagnóstico Arterial (CUiiDARTE), Facultad de Medicina, Universidad de la República, Montevideo, Uruguay.
Sección Hipertensión Arterial, Departamento de Cardiología, Hospital Privado de Comunidad, Mar del Plata, Argentina.
Front Cardiovasc Med. 2023 Jul 25;10:1207069. doi: 10.3389/fcvm.2023.1207069. eCollection 2023.
Recently it has been proposed a new approach to estimate aortic systolic blood pressure (aoSBP) without the need for specific devices, operator-dependent techniques and/or complex wave propagation models/algorithms. The approach proposes aoSBP can be quantified from brachial diastolic and mean blood pressure (bDBP, bMBP) as: aoSBP = bMBP/bDBP. It remains to be assessed to what extent the method and/or equation used to obtain the bMBP levels considered in aoSBP calculation may affect the estimated aoSBP, and consequently the agreement with aoSBP invasively recorded.
Brachial and aortic pressure were simultaneously obtained invasively (catheterization) and non-invasively (brachial oscillometry) in 89 subjects. aoSBP was quantified in seven different ways, using measured (oscillometry-derived) and calculated (six equations) mean blood pressure (MBP) levels. The agreement between invasive and estimated aoSBP was analyzed (Concordance correlation coefficient; Bland-Altman Test).
The ability of the equation "aoSBP = MBP/DBP" to (accurately) estimate (error <5 mmHg) invasive aoSBP depends on the method and equation considered to determine bMBP, and on the aoSBP levels (proportional error). Oscillometric bMBP and/or approaches that consider adjustments for heart rate or a form factor ∼40% (instead of the usual 33%) would be the best way to obtain the bMBP levels to be used to calculate aoSBP.
最近有人提出了一种新方法，无需特定设备、依赖操作者的技术和/或复杂的波传播模型/算法即可估算主动脉收缩压（aoSBP）。该方法提出，aoSBP可根据肱动脉舒张压和平均血压（bDBP、bMBP）进行量化，公式为：aoSBP = bMBP/bDBP。用于获得aoSBP计算中所考虑的bMBP水平的方法和/或方程在多大程度上会影响估算的aoSBP，进而影响与有创记录的aoSBP的一致性，仍有待评估。
对89名受试者同时进行有创（导管插入术）和无创（肱动脉示波法）测量肱动脉和主动脉压力。使用测量的（示波法得出的）和计算的（六个方程）平均血压（MBP）水平，以七种不同方式对aoSBP进行量化。分析有创和估算的aoSBP之间的一致性（一致性相关系数；布兰德-奥特曼检验）。
“aoSBP = MBP/DBP”方程准确估算（误差＜５mmHg）有创aoSBP的能力取决于用于确定bMBP的方法和方程，以及aoSBP水平（比例误差）。示波法bMBP和/或考虑心率调整或约40%（而非通常的33%）的形状因子的方法，将是获取用于计算aoSBP的bMBP水平的最佳方式。
