Noninvasive measurement of blood pressure variability: accuracy of the Finometer monitor and comparison with the Finapres device

Abstract

To assess the accuracy of spectral indices of arterial pressure variability and baroreflex sensitivity obtained from beat-by-beat noninvasive blood pressure recordings by the Finometer device, we compared these measures with those obtained from intra-arterial recordings. The performance of the Finometer was also compared to the traditional Finapres device. In 19 cardiac disease patients, including myocardial infarction, heart failure and cardiac transplant, we estimated the power of systolic and diastolic pressures in the VLF (0.01-0.04 Hz), LF (0.04-0.15 Hz) and HF (0.15-0.45 Hz) bands and computed absolute and percentage errors relative to intra-arterial brachial pressure. We also computed the characteristic frequency of each band (i.e. the barycentric frequency of spectral components identified in the band). The variability of systolic pressure in the VLF and LF bands was markedly overestimated by both the Finometer and Finapres (p < 0.01), with percentage median errors of respectively 130% and 103% (Finometer), and 134% and 78% (Finapres). The HF power was substantially unchanged using the Finometer and reduced using the Finapres (-28%, p < 0.05). The limits of agreement between noninvasive and invasive spectral measurements were wide. Linear system analysis showed that most (>80%) of the power of noninvasive signals was linearly related to the power of the invasive signal. The characteristic frequency of each band was substantially preserved in both noninvasive signals. The results for diastolic pressure were similar, but the Finapres errors in the VLF and LF bands were lower. Baroreflex sensitivity was significantly underestimated by both devices (Finometer: -31%, Finapres: -24%). Despite previous studies having shown that brachial artery waveform reconstruction performed by the Finometer has improved the accuracy of blood pressure measurement compared to the Finapres device, measurement of blood pressure variability in cardiac disease patients provides worse results in most spectral parameters and a better accuracy only in the HF band of systolic pressure.

A Single Session of Neuromuscular Electrical Stimulation Enhances Vascular Endothelial Function and Peripheral Blood Circulation in Patients With Acute Myocardial Infarction

“…15) Blood pressure variability was also assessed using variances of beat-to-beat systolic blood pressure obtained from the finger sphygmomanometer. 16) The power spectra of the high-frequency component (0.15-0.40 Hz) of heart rate variability and low-frequency component (0.04-0.15 Hz) of blood pressure variability were analyzed by the maximum entropy method using MemCalc (TARAWA, GMS, Tokyo). 15,16) The high-frequency and low-frequency components reflect cardiac parasympathetic and sympathetic activities, respectively.…”

“…16) The power spectra of the high-frequency component (0.15-0.40 Hz) of heart rate variability and low-frequency component (0.04-0.15 Hz) of blood pressure variability were analyzed by the maximum entropy method using MemCalc (TARAWA, GMS, Tokyo). 15,16) The high-frequency and low-frequency components reflect cardiac parasympathetic and sympathetic activities, respectively. [15][16][17][18] Transcutaneous oxygen pressure in foot (Foot-tcPO 2 ) was measured as a parameter of peripheral blood circulation using a transcutaneous oxygen pressure device (PO-850, Sumitomo Electric Hightechs, Tokyo).…”

“…15,16) The high-frequency and low-frequency components reflect cardiac parasympathetic and sympathetic activities, respectively. [15][16][17][18] Transcutaneous oxygen pressure in foot (Foot-tcPO 2 ) was measured as a parameter of peripheral blood circulation using a transcutaneous oxygen pressure device (PO-850, Sumitomo Electric Hightechs, Tokyo). 19) After the patients had rested on a bed in the supine position for 15 minutes, a probe heated to 43.5°C was attached to their first intermetatarsal space on the dorsum of the right foot using a double-sided adhesive ring supplied by the manufacturer.…”

Characteristics and Theoretical Foundations of Methods to Analyze Heart Rate Variability

“…Рівень барорефлекторної чутливості, що оці-нювався крос-спектральним методом по когерент-ності між коливаннями кардіоінтервалу та систоліч-ного артеріального тиску у діапазоні 0,067-0,133 Гц, на 116 молодих чоловіках показав високий рі-вень відтворюваності при триразових повторних вимірах з інтервалом у один тиждень [67]. Maestri R. et al [83] при повторних вимірюваннях парамет-рів спонтанної барорефлекторної чутливості на 44 здорових чоловіках і 57 -із інфарктом міокарду знайшли їх добру повторюваність.…”

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“…У результаті тиск у манжеті починає повторювати зміни тиску у артерії. За допомогою приладів Finapres можна оцінювати хвильову структуру ко-ливань артеріального тиску та чутливість бароре-флексу в основному з такою ж точністю, як і при катетеризації артеріальних судин [83,117]. У US National Library of Medicine на даний момент (квітень 2017 року) існує 800 посилань на дослі-дження, виконані з використанням такої технології.…”