Aortic systolic and pulse pressure invasively and non-invasively obtained: Comparative analysis of recording techniques, arterial sites of measurement, waveform analysis algorithms and calibration methods
Background: The non-invasive estimation of aortic systolic (aoSBP) and pulse pressure (aoPP) is achieved by a great variety of devices, which differ markedly in the: 1) principles of recording (applied technology), 2) arterial recording site, 3) model and mathematical analysis applied to signals, an...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2023-01-01
|
| Series: | Frontiers in Physiology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fphys.2023.1113972/full |
| _version_ | 1828063236159700992 |
|---|---|
| author | Daniel Bia Yanina Zócalo Ramiro Sánchez Gustavo Lev Oscar Mendiz Franco Pessana Agustín Ramirez Edmundo I. Cabrera-Fischer |
| author_facet | Daniel Bia Yanina Zócalo Ramiro Sánchez Gustavo Lev Oscar Mendiz Franco Pessana Agustín Ramirez Edmundo I. Cabrera-Fischer |
| author_sort | Daniel Bia |
| collection | DOAJ |
| description | Background: The non-invasive estimation of aortic systolic (aoSBP) and pulse pressure (aoPP) is achieved by a great variety of devices, which differ markedly in the: 1) principles of recording (applied technology), 2) arterial recording site, 3) model and mathematical analysis applied to signals, and/or 4) calibration scheme. The most reliable non-invasive procedure to obtain aoSBP and aoPP is not well established.Aim: To evaluate the agreement between aoSBP and aoPP values invasively and non-invasively obtained using different: 1) recording techniques (tonometry, oscilometry/plethysmography, ultrasound), 2) recording sites [radial, brachial (BA) and carotid artery (CCA)], 3) waveform analysis algorithms (e.g., direct analysis of the CCA pulse waveform vs. peripheral waveform analysis using general transfer functions, N-point moving average filters, etc.), 4) calibration schemes (systolic-diastolic calibration vs. methods using BA diastolic and mean blood pressure (bMBP); the latter calculated using different equations vs. measured directly by oscillometry, and 5) different equations to estimate bMBP (i.e., using a form factor of 33% (“033”), 41.2% (“0412”) or 33% corrected for heart rate (“033HR”).Methods: The invasive aortic (aoBP) and brachial pressure (bBP) (catheterization), and the non-invasive aoBP and bBP were simultaneously obtained in 34 subjects. Non-invasive aoBP levels were obtained using different techniques, analysis methods, recording sites, and calibration schemes.Results: 1) Overall, non-invasive approaches yielded lower aoSBP and aoPP levels than those recorded invasively. 2) aoSBP and aoPP determinations based on CCA recordings, followed by BA recordings, were those that yielded values closest to those recorded invasively. 3) The “033HR” and “0412” calibration schemes ensured the lowest mean error, and the “033” method determined aoBP levels furthest from those recorded invasively. 4) Most of the non-invasive approaches considered overestimated and underestimated aoSBP at low (i.e., 80 mmHg) and high (i.e., 180 mmHg) invasive aoSBP values, respectively. 5) The higher the invasively measured aoPP, the higher the level of underestimation provided by the non-invasive methods.Conclusion: The recording method and site, the mathematical method/model used to quantify aoSBP and aoPP, and to calibrate waveforms, are essential when estimating aoBP. Our study strongly emphasizes the need for methodological transparency and consensus for the non-invasive aoBP assessment. |
| first_indexed | 2024-04-10T22:41:05Z |
| format | Article |
| id | doaj.art-d793162c19e34d1693d46aa51bf2739a |
| institution | Directory Open Access Journal |
| issn | 1664-042X |
| language | English |
| last_indexed | 2024-04-10T22:41:05Z |
| publishDate | 2023-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Physiology |
| spelling | doaj.art-d793162c19e34d1693d46aa51bf2739a2023-01-16T05:33:04ZengFrontiers Media S.A.Frontiers in Physiology1664-042X2023-01-011410.3389/fphys.2023.11139721113972Aortic systolic and pulse pressure invasively and non-invasively obtained: Comparative analysis of recording techniques, arterial sites of measurement, waveform analysis algorithms and calibration methodsDaniel Bia0Yanina Zócalo1Ramiro Sánchez2Gustavo Lev3Oscar Mendiz4Franco Pessana5Agustín Ramirez6Edmundo I. Cabrera-Fischer7Departamento de Fisiología, Centro Universitario de Investigación, Innovación y Diagnóstico Arterial (CUiiDARTE), Facultad de Medicina, Universidad de la República, Montevideo, UruguayDepartamento de Fisiología, Centro Universitario de Investigación, Innovación y Diagnóstico Arterial (CUiiDARTE), Facultad de Medicina, Universidad de la República, Montevideo, UruguayMetabolic Unit and Hypertension Unit, University Hospital, Favaloro Foundation, Buenos Aires, ArgentinaDepartment of Interventional Cardiology, University Hospital, Favaloro Foundation, Buenos Aires, ArgentinaDepartment of Interventional Cardiology, University Hospital, Favaloro Foundation, Buenos Aires, ArgentinaDepartment of Information Technology, Engineering and Exact Sciences Faculty, Favaloro University, Buenos Aires, ArgentinaIMETTYB Favaloro University—CONICET, Buenos Aires, ArgentinaIMETTYB Favaloro University—CONICET, Buenos Aires, ArgentinaBackground: The non-invasive estimation of aortic systolic (aoSBP) and pulse pressure (aoPP) is achieved by a great variety of devices, which differ markedly in the: 1) principles of recording (applied technology), 2) arterial recording site, 3) model and mathematical analysis applied to signals, and/or 4) calibration scheme. The most reliable non-invasive procedure to obtain aoSBP and aoPP is not well established.Aim: To evaluate the agreement between aoSBP and aoPP values invasively and non-invasively obtained using different: 1) recording techniques (tonometry, oscilometry/plethysmography, ultrasound), 2) recording sites [radial, brachial (BA) and carotid artery (CCA)], 3) waveform analysis algorithms (e.g., direct analysis of the CCA pulse waveform vs. peripheral waveform analysis using general transfer functions, N-point moving average filters, etc.), 4) calibration schemes (systolic-diastolic calibration vs. methods using BA diastolic and mean blood pressure (bMBP); the latter calculated using different equations vs. measured directly by oscillometry, and 5) different equations to estimate bMBP (i.e., using a form factor of 33% (“033”), 41.2% (“0412”) or 33% corrected for heart rate (“033HR”).Methods: The invasive aortic (aoBP) and brachial pressure (bBP) (catheterization), and the non-invasive aoBP and bBP were simultaneously obtained in 34 subjects. Non-invasive aoBP levels were obtained using different techniques, analysis methods, recording sites, and calibration schemes.Results: 1) Overall, non-invasive approaches yielded lower aoSBP and aoPP levels than those recorded invasively. 2) aoSBP and aoPP determinations based on CCA recordings, followed by BA recordings, were those that yielded values closest to those recorded invasively. 3) The “033HR” and “0412” calibration schemes ensured the lowest mean error, and the “033” method determined aoBP levels furthest from those recorded invasively. 4) Most of the non-invasive approaches considered overestimated and underestimated aoSBP at low (i.e., 80 mmHg) and high (i.e., 180 mmHg) invasive aoSBP values, respectively. 5) The higher the invasively measured aoPP, the higher the level of underestimation provided by the non-invasive methods.Conclusion: The recording method and site, the mathematical method/model used to quantify aoSBP and aoPP, and to calibrate waveforms, are essential when estimating aoBP. Our study strongly emphasizes the need for methodological transparency and consensus for the non-invasive aoBP assessment.https://www.frontiersin.org/articles/10.3389/fphys.2023.1113972/fullapplanation tonometrycalibrationcatheterismcentral aortic blood pressureinvasive recordsnon-invasive records |
| spellingShingle | Daniel Bia Yanina Zócalo Ramiro Sánchez Gustavo Lev Oscar Mendiz Franco Pessana Agustín Ramirez Edmundo I. Cabrera-Fischer Aortic systolic and pulse pressure invasively and non-invasively obtained: Comparative analysis of recording techniques, arterial sites of measurement, waveform analysis algorithms and calibration methods Frontiers in Physiology applanation tonometry calibration catheterism central aortic blood pressure invasive records non-invasive records |
| title | Aortic systolic and pulse pressure invasively and non-invasively obtained: Comparative analysis of recording techniques, arterial sites of measurement, waveform analysis algorithms and calibration methods |
| title_full | Aortic systolic and pulse pressure invasively and non-invasively obtained: Comparative analysis of recording techniques, arterial sites of measurement, waveform analysis algorithms and calibration methods |
| title_fullStr | Aortic systolic and pulse pressure invasively and non-invasively obtained: Comparative analysis of recording techniques, arterial sites of measurement, waveform analysis algorithms and calibration methods |
| title_full_unstemmed | Aortic systolic and pulse pressure invasively and non-invasively obtained: Comparative analysis of recording techniques, arterial sites of measurement, waveform analysis algorithms and calibration methods |
| title_short | Aortic systolic and pulse pressure invasively and non-invasively obtained: Comparative analysis of recording techniques, arterial sites of measurement, waveform analysis algorithms and calibration methods |
| title_sort | aortic systolic and pulse pressure invasively and non invasively obtained comparative analysis of recording techniques arterial sites of measurement waveform analysis algorithms and calibration methods |
| topic | applanation tonometry calibration catheterism central aortic blood pressure invasive records non-invasive records |
| url | https://www.frontiersin.org/articles/10.3389/fphys.2023.1113972/full |
| work_keys_str_mv | AT danielbia aorticsystolicandpulsepressureinvasivelyandnoninvasivelyobtainedcomparativeanalysisofrecordingtechniquesarterialsitesofmeasurementwaveformanalysisalgorithmsandcalibrationmethods AT yaninazocalo aorticsystolicandpulsepressureinvasivelyandnoninvasivelyobtainedcomparativeanalysisofrecordingtechniquesarterialsitesofmeasurementwaveformanalysisalgorithmsandcalibrationmethods AT ramirosanchez aorticsystolicandpulsepressureinvasivelyandnoninvasivelyobtainedcomparativeanalysisofrecordingtechniquesarterialsitesofmeasurementwaveformanalysisalgorithmsandcalibrationmethods AT gustavolev aorticsystolicandpulsepressureinvasivelyandnoninvasivelyobtainedcomparativeanalysisofrecordingtechniquesarterialsitesofmeasurementwaveformanalysisalgorithmsandcalibrationmethods AT oscarmendiz aorticsystolicandpulsepressureinvasivelyandnoninvasivelyobtainedcomparativeanalysisofrecordingtechniquesarterialsitesofmeasurementwaveformanalysisalgorithmsandcalibrationmethods AT francopessana aorticsystolicandpulsepressureinvasivelyandnoninvasivelyobtainedcomparativeanalysisofrecordingtechniquesarterialsitesofmeasurementwaveformanalysisalgorithmsandcalibrationmethods AT agustinramirez aorticsystolicandpulsepressureinvasivelyandnoninvasivelyobtainedcomparativeanalysisofrecordingtechniquesarterialsitesofmeasurementwaveformanalysisalgorithmsandcalibrationmethods AT edmundoicabrerafischer aorticsystolicandpulsepressureinvasivelyandnoninvasivelyobtainedcomparativeanalysisofrecordingtechniquesarterialsitesofmeasurementwaveformanalysisalgorithmsandcalibrationmethods |