Aortic systolic pressure derived with different calibration methods

Wassertheurer, Siegfried; Hametner, Bernhard; Mayer, Christopher C.; Hafez, Ahmed; Negishi, Kazuaki; Papaioannou, Theodore G.; Protogerou, Athanase D.; Sharman, James E.; Weber, Thomas

doi:10.1097/mbp.0000000000000319

Cited by 24 publications

(19 citation statements)

References 30 publications

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“…This yielded a total of 21 publications for this meta-analysis. 1–4,8,9,11–18,21,22,24–28 The 21 published reports include 29 subgroup analyses, comprising 15 820 individual comparisons in 13 460 individual participants, as some studies made multiple comparisons in the same participants.…”

Section: Resultsmentioning

confidence: 99%

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Pulse Wave Calibration and Implications for Blood Pressure Measurement: Systematic Review and Meta-Analysis

et al. 2021

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Central aortic systolic pressure (CASP) can be estimated via filtering of the peripheral pulse wave (PPW) following calibration to brachial blood pressure. Recent studies suggest PPW calibration to mean arterial pressure (MAP) and diastolic BP (DBP) provides more accurate CASP estimates (CASP MD ) versus conventional calibration to systolic BP (SBP) and DBP (CASP SD ). However, the peak of the MAP-DBP calibrated PPW, that is, SBP MD , is rarely reported or used for BP amplification calculations, despite CASP MD being derived from it. We aimed to calculate the unreported SBP MD from studies using MAP-DBP calibration for estimation of CASP MD and compared it with oscillometric brachial SBP (brSBP). Medline database was searched to March 18, 2020. Meta-analysis includes studies reporting noninvasive CASP SD , CASP MD , brSBP, and brachial DBP. SBP MD was calculated using linear function equations. Data from 21 studies used 8 different BP monitors (13 460 participants, mean age: 54±10 years, 57% female, brachial blood pressure: 130±14/79±9 mm Hg). Weighted mean difference between SBP MD and brSBP was 10 mm Hg (range, −2 to 17 mm Hg) and appeared device specific. Calibration of brachial versus radial PPWs to brachial blood pressure showed a greater disparity between SBP MD and brSBP (14 versus 2 mm Hg). BP amplification was similar comparing SBP-DBP versus MAP-DBP calibrations (brSBP-CASP SD versus SBP MD -CASP MD : 9 versus 11 mm Hg), with no instances of reverse BP amplification. PPWs calibrated to MAP-DBP to derive CASP MD generates SBP MD that differs markedly from brSBP with some oscillometric BP monitors. These findings have important implications for BP monitor accuracy, BP amplification, PPW calibration recommendations, and studies of associations between CASP versus SBP and outcomes.

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Section: Resultsmentioning

confidence: 99%

“…Average values are reported as mean±SD. Summary data from 3 studies 16–18 was converted to mean±SD values using previously published formulas 29 when needed. Summary data in Tables 1 and 2 were calculated with commonly used weighted mean formula () and pooled SD formula ().…”

Section: Methodsmentioning

confidence: 99%

Pulse Wave Calibration and Implications for Blood Pressure Measurement: Systematic Review and Meta-Analysis

et al. 2021

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“…Indeed, major organs get their blood flow from the aorta, not the brachial artery . It has been established that using type II calibration provides more accurate results than using type I calibration . Our study shows that in women, type II noninvasive central BP outperforms the brachial cuff BP, whereas in men, the brachial cuff provides the most accurate results.…”

Section: Discussionmentioning

confidence: 99%

Accuracy Difference of Noninvasive Blood Pressure Measurements by Sex and Height

et al. 2022

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Key Points Question Do noninvasive brachial cuff blood pressure (BP) measurements accurately estimate the invasive aortic (or true) BP in men and women? Findings In this cross-sectional study of 500 patients undergoing cardiac catheterization at a tertiary care academic hospital, women had significantly higher invasively measured aortic systolic BP (SBP) compared with men with similar brachial cuff SBP. This disparity was mostly explained by a difference in height, with shorter height associated with greater underestimation of the invasive aortic SBP by the brachial cuff. Meaning These findings suggest that brachial cuff BP may significantly underestimate true aortic SBP in women, which may lead to unrecognized undertreatment of women compared with men and could partly explain why women are at higher risk of cardiovascular diseases for a given brachial cuff BP.

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“…cSBP obtained calibrating to DBP/MBPosc has shown: (1) better correlation with cardiac hypertrophy when using 24-hour ambulatory cSBP data[26], (2) superior discriminatory capability, associated with significant improvement in reclassification to identify cardiac structural abnormalities in community-based patients with stage A heart failure[27], (3) association with clinical outcomes in patients with chronic kidney disease[28], (4) enhanced association with cardiac structural features in children, adolescents and young adults [29]. Additionally, comparatively, cSBP obtained calibrating to DBP/MBPosc showed a weaker association with pSBP, which would increase the independent predictive capacity[29,30,31]. The value of considering cSBP apart from pSBP has been discussed and considered over the last two decades.…”

Section: Discussionmentioning

confidence: 99%

Aortic pressure and forward and backward wave components in children, adolescents and young-adults: Agreement between brachial oscillometry, radial and carotid tonometry data and analysis of factors associated with their differences

et al. 2019

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Non-invasive devices used to estimate central (aortic) systolic pressure (cSBP), pulse pressure (cPP) and forward (Pf) and backward (Pb) wave components from blood pressure (BP) or surrogate signals differ in arteries studied, techniques, data-analysis algorithms and/or calibration schemes (e.g. calibrating to calculated [MBPc] or measured [MBPosc] mean pressure). The aims were to analyze, in children, adolescents and young-adults (1) the agreement between cSBP, cPP, Pf and Pb obtained using carotid (CT) and radial tonometry (RT) and brachial-oscillometry (BOSC); and (2) explanatory factors for the differences between approaches-data and between MBPosc and MBPc.1685 subjects (mean/range age: 14/3-35 y.o.) assigned to three age-related groups (3–12; 12–18; 18–35 y.o.) were included. cSBP, cPP, Pf and Pb were assessed with BOSC (Mobil-O-Graph), CT and RT (SphygmoCor) records. Two calibration schemes were considered: MBPc and MBPosc for calibrations to similar BP levels. Correlation, Bland-Altman tests and multiple regression models were applied. Systematic and proportional errors were observed; errors´ statistical significance and values varied depending on the parameter analyzed, methods compared and group considered. The explanatory factors for the differences between data obtained from the different approaches varied depending on the methods compared. The highest cSBP and cPP were obtained from CT; the lowest from RT. Independently of the technique, parameter or age-group, higher values were obtained calibrating to MBPosc. Age, sex, heart rate, diastolic BP, body weight or height were explanatory factors for the differences in cSBP, cPP, Pf or Pb. Brachial BP levels were explanatory factors for the differences between MBPosc and MBPc.

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Aortic systolic pressure derived with different calibration methods

Abstract: In contrast to aSBP1, the association between bSBP and aSBP2 is significantly less dominant and therefore aSBP2 may have potential prognostic superiority over bSBP.

Cited by 24 publications

References 30 publications

Pulse Wave Calibration and Implications for Blood Pressure Measurement: Systematic Review and Meta-Analysis

Pulse Wave Calibration and Implications for Blood Pressure Measurement: Systematic Review and Meta-Analysis

Accuracy Difference of Noninvasive Blood Pressure Measurements by Sex and Height

Aortic pressure and forward and backward wave components in children, adolescents and young-adults: Agreement between brachial oscillometry, radial and carotid tonometry data and analysis of factors associated with their differences

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