Mean arterial pressure estimated by brachial pulse wave analysis and comparison with currently used algorithms

Grillo, Andrea; Salvi, Paolo; Furlanis, Giulia; Baldi, Corrado; Rovina, Matteo; Salvi, Lucia; Faini, Andrea; Bilo, Grzegorz; Fabris, Bruno; Carretta, Renzo; Bénétos, Athanase; Parati, Gianfranco

doi:10.1097/hjh.0000000000002564

Cited by 30 publications

(26 citation statements)

References 29 publications

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“…Conversely, b P m used for calibrating the tonometer pressure waveform was estimated using average FF previously reported for the brachial artery; FF = 0.43 (Segers et al, 2009 ). Here, carotid t FF , determined from the acquired tonometer waveforms, averaged 0.45 but ranged between 0.36 and 0.57, and a similar variability was reported for the brachial artery (Grillo et al, 2020 ). Hence, neglecting the age‐dependence and inter‐subjects variability of the brachial FF likely affected the accuracy of the calibration of the tonometer pressure waveforms.…”

Section: Discussionsupporting

confidence: 79%

“…Hence, neglecting the age‐dependence and inter‐subjects variability of the brachial FF likely affected the accuracy of the calibration of the tonometer pressure waveforms. Grillo et al ( 2020 ) recently proposed an alternative method for the estimation of a subject‐specific brachial FF derived from b P d and gender. They showed that the method predicts age‐differences of brachial FF more effectively in middle‐aged and older adults.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2021

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Section: Discussionsupporting

confidence: 79%

Section: Discussionmentioning

confidence: 99%

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

et al. 2021

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“…Finally, and very importantly, the accuracy of the DCBP formula is dependent upon minimizing BPs measurement errors, but this is a limitation common to nearly all clinical devices aimed at non-invasively estimating cSBP. A reliable MBP value is especially needed, and it must be noted that the best empirical formula to estimate MBP from peripheral SBP and DBP is still under discussion and that the importance of this issue has been stressed (23,24,(42)(43)(44)(45).…”

Section: Discussionmentioning

confidence: 99%

New Method to Estimate Central Systolic Blood Pressure From Peripheral Pressure: A Proof of Concept and Validation Study

Chemla

Millasseau²,

Hamzaoui

et al. 2021

Front. Cardiovasc. Med.

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Objective: The non-invasive estimation of central systolic blood pressure (cSBP) is increasingly performed using new devices based on various pulse acquisition techniques and mathematical analyses. These devices are most often calibrated assuming that mean (MBP) and diastolic (DBP) BP are essentially unchanged when pressure wave travels from aorta to peripheral artery, an assumption which is evidence-based. We tested a new empirical formula for the direct central blood pressure estimation of cSBP using MBP and DBP only (DCBP = MBP2/DBP).Methods and Results: First, we performed a post-hoc analysis of our prospective invasive high-fidelity aortic pressure database (n = 139, age 49 ± 12 years, 78% men). The cSBP was 146.0 ± 31.1 mmHg. The error between aortic DCBP and cSBP was −0.9 ± 7.4 mmHg, and there was no bias across the cSBP range (82.5–204.0 mmHg). Second, we analyzed 64 patients from two studies of the literature in whom invasive high-fidelity pressures were simultaneously obtained in the aorta and brachial artery. The weighed mean error between brachial DCBP and cSBP was 1.1 mmHg. Finally, 30 intensive care unit patients equipped with fluid-filled catheter in the radial artery were prospectively studied. The cSBP (115.7 ± 18.2 mmHg) was estimated by carotid tonometry. The error between radial DCBP and cSBP was −0.4 ± 5.8 mmHg, and there was no bias across the range.Conclusion: Our study shows that cSBP could be reliably estimated from MBP and DBP only, provided BP measurement errors are minimized. DCBP may have implications for assessing cardiovascular risk associated with cSBP on large BP databases, a point that deserves further studies.

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“…An additional possibility was that MAP variability might more directly decrease the myocardial perfusion. As MAP was a main driving force for vital organ perfusion (15), repeated transient reductions in MAP over time might put cardiac tissue at increased risk of relative hypoperfusion. More detailed studies elucidating the role of MAP variability, and the relevant mechanisms, in the development of death and HF are clearly needed to help refine our understanding of and guidance for optimal BP management.…”

Section: Discussionmentioning

confidence: 99%

“…However, few studies to date have evaluated the potential impact of long-term mean arterial pressure (MAP) variability on CVD and death. MAP is considered to be a steady component along which BP fluctuates between the SBP and DBP levels and a main driving force for vital organ perfusion (15). The clinical prognostic power of MAP in predicting the risk for CVD was reported to be even superior to that of SBP and DBP (16).…”

Section: Introductionmentioning

confidence: 99%

Long-Term Visit-to-Visit Mean Arterial Pressure Variability and the Risk of Heart Failure and All-Cause Mortality

Liu

Chen

Zhang

et al. 2021

Front. Cardiovasc. Med.

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Background: Systolic or diastolic blood pressure (BP) variability is associated with an increased risk of cardiovascular events. We assessed whether BP variability measured by mean arterial pressure (MAP) was associated with increased risk of heart failure (HF) and death in individuals with or without hypertension.Methods: We evaluated 9,305 Atherosclerosis Risk in Communities (ARIC) study participants with or without hypertension and calculated BP variability based on MAP values from visit 1 to 4 [expressed as standard deviation (SD), average real variability (ARV), coefficient of variation (CV), and variability independent of the mean (VIM)]. Multivariate-adjusted Cox regression model and restricted cubic spline curve were used to evaluate the associations of MAP variability with all-cause mortality and HF.Results: During a median follow-up of 16.8 years, 1,511 had an HF event and 2,903 died. Individuals in the highest quartile of VIM were both associated with a 21% higher risk of all-cause mortality [hazard ratio (HR), 1.21; 95% CI, 1.09–1.35] and HF (HR, 1.21; 95% CI, 1.04–1.39) compared with the lowest quartile of VIM. Cubic spline curves reveal that the risk of deaths and HF increased with MAP variability when it reached a higher level. Results were similar in individuals with normotension (all-cause mortality: HR, 1.30; 95% CI, 1.09–1.55; HF, HR, 1.49; 95% CI, 1.12–1.98).Conclusions: In individuals with or without hypertension, greater visit-to-visit MAP variability was associated with a higher risk of all-cause mortality and HF, indicating that the BP variability assessed by MAP might be a potential risk factor for HF and death.

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Mean arterial pressure estimated by brachial pulse wave analysis and comparison with currently used algorithms

Cited by 30 publications

References 29 publications

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

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

New Method to Estimate Central Systolic Blood Pressure From Peripheral Pressure: A Proof of Concept and Validation Study

Long-Term Visit-to-Visit Mean Arterial Pressure Variability and the Risk of Heart Failure and All-Cause Mortality

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