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Transfer-function-free technique for the noninvasive determination of the human arterial pressure waveform.

Published version
Peer-reviewed

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Authors

Giudici, Alessandro  ORCID logo  https://orcid.org/0000-0002-8288-3980
Palombo, Carlo 
Morizzo, Carmela 
Kozakova, Michaela 
Cruickshank, J Kennedy 

Abstract

The estimation of central aortic blood pressure is a cardinal measurement, carrying effective physiological, and prognostic data beyond routine peripheral blood pressure. Transfer function-based devices effectively estimate aortic systolic and diastolic blood pressure from peripheral pressure waveforms, but the reconstructed pressure waveform seems to preserve features of the peripheral waveform. We sought to develop a new method for converting the local diameter distension waveform into a pressure waveform, through an exponential function whose parameters depend on the local wave speed. The proposed method was then tested at the common carotid artery. Diameter and blood velocity waveforms were acquired via ultrasound at the right common carotid artery while simultaneously recording pressure at the left common carotid artery via tonometer in 203 people (122 men, 50 ± 18 years). The wave speed was noninvasively estimated via the lnDU-loop method and then used to define the exponential function to convert the diameter into pressure. Noninvasive systolic and mean pressures estimated by the new technique were 3.8 ± 21.8 (p = 0.015) and 2.3 ± 9.6 mmHg (p = 0.011) higher than those obtained using tonometery. However, differences were much reduced and not significant in people >35 years (0.6 ± 18.7 and 0.8 ± 8.3 mmHg, respectively). This proof of concept study demonstrated that local wave speed, estimated from noninvasive local measurement of diameter and flow velocity, can be used to determine an exponential function that describes the relationship between local pressure and diameter. This pressure-diameter function can then be used for the noninvasive estimation of local arterial pressure.

Description

Funder: Innovative Medicines Initiative

Keywords

carotid artery, hypertension, local wave speed, noninvasive estimation of pressure, pressure, Adolescent, Adult, Aged, Arterial Pressure, Blood Pressure Determination, Carotid Arteries, Cerebrovascular Circulation, Female, Humans, Male, Models, Cardiovascular

Journal Title

Physiol Rep

Conference Name

Journal ISSN

2051-817X
2051-817X

Volume Title

9

Publisher

Wiley
Sponsorship
British Heart Foundation (None)