Estimating central SBP from the peripheral pulse: influence of waveform analysis and calibration error

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Abstract

Objective: To compare estimation of central cSBP by application of a generalized transfer function (GTF) to a peripheral arterial waveform and from the late systolic shoulder (SBP2) of such a waveform and assess errors introduced by noninvasive calibration of the waveform.

Methods: The digital arterial pulse was acquired noninvasively with a servo-controlled finger cuff. A high fidelity pressure tipped catheter was placed in the proximal aortic root. Measurements were made at baseline (n = 40), after nitrovasodilation, handgrip exercise (n = 18) and during pacing (n = 10). Estimates of cSBP obtained using a GTF and from SBP2 (using an algorithm applied to individual cardiac cycles) of the digital arterial waveform were compared with values measured at the aortic root.

Results: When arterial waveforms were calibrated from aortic intra-arterial mean and DBP there was close agreement between estimated and measured cSBP: mean difference between estimated and measured cSBP (SD): 1.0 (5.7) and -0.7 (5.5) mmHg for GTF and SBP2, respectively. Noninvasive oscillometric calibration increased variability in estimation of cSBP [mean difference, 1.3 (11) mmHg for SBP2] but estimates of the cSBP to peripheral systolic pressure increment from oscillometric calibration of SBP2 agreed well with those obtained using invasive calibration [mean difference -2.4 (6.1) mmHg].

Conclusion: SBP2 potentially provides a simple measure of cSBP and is of comparable accuracy to a GTF. Noninvasive calibration increases variability for both methods but has less effect on the cSBP to peripheral SBP increment.
Original languageEnglish
Pages (from-to)1357 - 1366
Number of pages10
JournalJournal of Hypertension
Volume29
Issue number7
DOIs
Publication statusPublished - Jul 2011

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