Department of Medical Engineering California Institute of Technology Pasadena CA USA.
J Am Heart Assoc. 2024 Apr 16;13(8):e033290. doi: 10.1161/JAHA.123.033290. Epub 2024 Apr 9.
Noninvasive pulse waveform analysis is valuable for central cardiovascular assessment, yet controversies persist over its validity in peripheral measurements. Our objective was to compare waveform features from a cuff system with suprasystolic blood pressure hold with an invasive aortic measurement.
This study analyzed data from 88 subjects undergoing concurrent aortic catheterization and brachial pulse waveform acquisition using a suprasystolic blood pressure cuff system. Oscillometric blood pressure (BP) was compared with invasive aortic systolic BP and diastolic BP. Association between cuff and catheter waveform features was performed on a set of 15 parameters inclusive of magnitudes, time intervals, pressure-time integrals, and slopes of the pulsations. The evaluation covered both static (subject-averaged values) and dynamic (breathing-induced fluctuations) behaviors. Peripheral BP values from the cuff device were higher than catheter values (systolic BP-residual, 6.5 mm Hg; diastolic BP-residual, 12.4 mm Hg). Physiological correction for pressure amplification in the arterial system improved systolic BP prediction (=0.83). Dynamic calibration generated noninvasive BP fluctuations that reflect those invasively measured (systolic BP Pearson =0.73, <0.001; diastolic BP Pearson =0.53, <0.001). Static and dynamic analyses revealed a set of parameters with strong associations between catheter and cuff (Pearson >0.5, <0.001), encompassing magnitudes, timings, and pressure-time integrals but not slope-based parameters.
This study demonstrated that the device and methods for peripheral waveform measurements presented here can be used for noninvasive estimation of central BP and a subset of aortic waveform features. These results serve as a benchmark for central cardiovascular assessment using suprasystolic BP cuff-based devices and contribute to preserving system dynamics in noninvasive measurements.
无创脉搏波分析对于中心心血管评估具有重要价值，但外周测量的有效性仍存在争议。我们的目的是比较袖带系统超收缩压保持与有创主动脉测量的波形特征。
本研究分析了 88 例同时进行主动脉导管插入术和肱动脉脉搏波采集的患者的数据，使用超收缩压袖带系统。使用振荡血压（BP）与有创主动脉收缩压和舒张压进行比较。在包括幅度、时间间隔、压力-时间积分和脉动斜率在内的 15 个参数的集合上进行袖带和导管波形特征之间的关联。评估包括静态（受试者平均值）和动态（呼吸引起的波动）行为。袖带设备的外周 BP 值高于导管值（收缩压残余值，6.5mmHg；舒张压残余值，12.4mmHg）。对动脉系统中的压力放大进行生理校正可改善收缩压预测（=0.83）。动态校准生成的无创 BP 波动可反映有创测量的波动（收缩压 Pearson=0.73，<0.001；舒张压 Pearson=0.53，<0.001）。静态和动态分析显示了一组与导管和袖带具有强关联的参数（Pearson>0.5，<0.001），包括幅度、时间和压力-时间积分，但不包括基于斜率的参数。
本研究表明，这里提出的外周波形测量设备和方法可用于无创估计中心 BP 和主动脉波形特征的子集。这些结果为使用超收缩压袖带设备进行中心心血管评估提供了基准，并有助于保持无创测量中的系统动态。
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