Dhamotharan Vishaal, Cheng Hao-Min, Sung Shih-Hsien, Chen Chen-Huan, Landry Cederick, Freithaler Mark, Mahajan Aman, Shroff Sanjeev G, Hahn Jin-Oh, Mukkamala Ramakrishna
Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, United States.
School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
Front Physiol. 2025 Jun 18;16:1611096. doi: 10.3389/fphys.2025.1611096. eCollection 2025.
Oscillometry is the most popular blood pressure (BP) measurement method. Conventionally, BP is computed from the oscillation height versus cuff pressure function ("height oscillogram"). However, the oscillation shape also changes with cuff pressure. The objectives were to mathematically model oscillation shape and height variations as a function of cuff pressure and analyze these models using patient data.
The patient data comprised oscillometric arm cuff pressure and invasive brachial BP waveforms from 109 patients with diverse BPs. The data were analyzed to show that the oscillation area versus cuff pressure function ("area oscillogram") in particular could be reliably constructed while offering distinct information to the height oscillogram. An analytical model of the area oscillogram was developed with four unknown parameters representing the widths of the brachial artery compliance curve over positive and negative transmural pressure ranges and systolic and diastolic BPs. With invasive systolic and diastolic BPs as inputs, this model and a previous height oscillogram model with the same four parameters, were evaluated in terms of fitting individual patient oscillograms. The impact of key assumptions of the models was evaluated as well.
The area and height oscillogram models fitted the patient data well with errors of 6.9% ± 0.3% and 8.7% ± 0.4%, respectively. Cuff-arm-artery viscoelasticity affected the height oscillogram model fitting, while cuff-arm system nonlinearity may affect area oscillogram model parameter estimates.
Despite simplifying assumptions, the proposed area and previous height oscillogram models can reproduce measured patient oscillograms well. These models may ultimately help improve oscillometric BP measurement accuracy.
示波法是最常用的血压测量方法。传统上，血压是根据振荡高度与袖带压力函数（“高度示波图”）计算得出的。然而，振荡形状也会随袖带压力而变化。目的是对振荡形状和高度变化进行数学建模，将其作为袖带压力的函数，并使用患者数据对这些模型进行分析。
患者数据包括109例血压各异患者的示波法上臂袖带压力和有创肱动脉血压波形。分析数据以表明，尤其可以可靠地构建振荡面积与袖带压力函数（“面积示波图”），同时为高度示波图提供独特信息。开发了一个面积示波图的分析模型，该模型有四个未知参数，分别代表肱动脉顺应性曲线在正、负跨壁压力范围以及收缩压和舒张压时的宽度。以前面提到的有创收缩压和舒张压作为输入，对该模型和一个具有相同四个参数的先前高度示波图模型进行了个体患者示波图拟合评估。还评估了模型关键假设的影响。
面积和高度示波图模型对患者数据拟合良好，误差分别为6.9%±0.3%和8.7%±0.4%。袖带 - 手臂 - 动脉粘弹性影响高度示波图模型拟合，而袖带 - 手臂系统非线性可能影响面积示波图模型参数估计。
尽管有简化假设，但所提出的面积示波图模型和先前的高度示波图模型能够很好地重现测量得到的患者示波图。这些模型最终可能有助于提高示波法血压测量的准确性。
