The effects of pre-ejection period on post-exercise systolic blood pressure estimation using the pulse arrival time technique

Abstract

Pulse arrival time (PAT) is comprised of the vascular transit time (TT) through the arterial system and the pre-ejection period (PEP) in the heart. It has been used to predict arterial blood pressure (BP) without using a cuff. The aim of this study was to investigate the effects of including the PEP on the accuracy of cuffless systolic BP (SBP) estimation using the PAT technique in post-exercise recovery. Experiments were conducted on 22 normotensive participants. PAT, TT and PEP were determined from simultaneous measurements of the electrocardiogram, photoplethysmogram and impedance cardiogram. Moderate exercise induced significant (p < 0.05) increases in SBP and heart rate and significant (p < 0.05) decreases in PEP and PAT. Diastolic blood pressure and TT only varied insignificantly (p > 0.05). SBP was moderately correlated with PEP (r = -0.61) and PAT (r = -0.81). PAT and PEP were moderately correlated (r = 0.67). When SBP was estimated using least-squares methods, the differences between the measured and predicted SBP using PEP, PAT and TT were 0.0 ± 6.6, 0.0 ± 4.9 and 0.0 ± 9.3 mmHg, respectively. The findings suggested that PAT gives the best SBP prediction and PEP has some potential to predict blood pressure. The inclusion of PEP in the PAT measurement is necessary to facilitate accurate cuffless blood pressure prediction after exercise.

Weighing Scale-Based Pulse Transit Time is a Superior Marker of Blood Pressure than Conventional Pulse Arrival Time

“…Since the PEP component depends on the electromechanical functioning of the heart, it can change independently of PTT and thus BP. For example, PEP changes in the same direction as PTT during exercise4 but in the opposite direction of PTT during vasoconstriction5. Note that several studies of PAT have demonstrated good correlation with BP by employing only exercise-induced BP changes1.…”

Effects of slow and regular breathing exercise on cardiopulmonary coupling and blood pressure

“…There is a significant difference in PTT baseline between the SB section and the PB section at 7 BPM (from 172.8 ± 20.1 to 176.8 ± 19.2 ms, p < 0.001). As PTT is inversely proportional to BP [10,41], the increase in the PTT baseline also suggests the beneficial effect of the SPB procedure to cardiovascular system. Figure 6 shows an illustration of the variations of PTT, SBP and DBP during the SPB procedure (from the same subject with Fig.…”

The relationship between heart-carotid pulse transit time and carotid intima-media thickness in hypertensive patients

“…The lack of statistical significance for the thickened CIMT hypertensive group may be because the abnormal stiffening and thickening affected this linear relationship. The research by Zhang and coworkers 32 reported that the inclusion of PEP in the upper-body PTT measurement could improve the accuracy of cuffless blood pressure estimation after exercise. This may indicate that including PEP in PTT could better reflect the change of vessel states.…”