Measurement of Central Aortic Pulse Pressure: Noninvasive Brachial Cuff-Based Estimation by a Transfer Function Vs. a Novel Pulse Wave Analysis Method

Cheng, Hao Min; Sung, Shih Hsien; Shih, Yuan Ta; Chuang, Shao Yuan; Yu, Wen Chung; Chen, Chen Huan

doi:10.1038/ajh.2012.116

Cited by 27 publications

(24 citation statements)

References 37 publications

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“…Lack of consistency among Table 1. The stability validation of the periodic output of an artificial pulse generator system using the mean harmonic components ( cn ) and intra-class correlation coefficient, ICC (2,1 The p-value assesses the statistical significance of the null hypothesis that there is no correlation between five measurements (H 0 : ICC(2,1) ¼ 0); CI, confidence internal. Table 2.…”

Section: Discussionmentioning

confidence: 99%

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Reliability assessment for pulse wave measurement using artificial pulse generator

Chang

Wang

2015

Journal of Medical Engineering & Technology

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This study aimed to assess intrinsic reliabilities of devices for pulse wave measurement (PWM). An artificial pulse generator system was constructed to create a periodic pulse wave. The stability of the periodic output was tested by the DP103 pressure transducer. The pulse generator system was then used to evaluate the TD01C system. Test-re-test and inter-device reliability assessments were conducted on the TD01C system. First, 11 harmonic components of the pulse wave were calculated using Fourier series analysis. For each harmonic component, coefficient of variation (CV), intra-class correlation coefficient (ICC) and Bland-Altman plot were used to determine the degree of reliability of the TD01C system. In addition, device exclusion criteria were pre-specified to improve consistency of devices. The artificial pulse generator system was stable to evaluate intrinsic reliabilities of devices for PWM (ICCs > 0.95, p < 0.001). TD01C was reliable for repeated measurements (ICCs of test-re-test reliability > 0.95, p < 0.001; CVs all < 3%). Device exclusion criteria successfully excluded the device with defect; therefore, the criteria reduced inter-device CVs of harmonics and improved consistency of the selected devices for all harmonic components. This study confirmed the feasibility of intrinsic reliability assessment of devices for PWM using an artificial pulse generator system. Moreover, potential novel findings on the assessment combined with device exclusion criteria could be a useful method to select the measuring devices and to evaluate the qualities of them in PWM.

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Section: Discussionmentioning

confidence: 99%

“…The generalized transfer function (GTF), pulse wave velocity (PWV), augmentation index (AI) and harmonic analysis (HA) have been used to assess central aortic pressure [1], arterial stiffness [2] and other cardiovascular diseases [3].…”

Section: Introductionmentioning

confidence: 99%

Reliability assessment for pulse wave measurement using artificial pulse generator

Chang

Wang

2015

Journal of Medical Engineering & Technology

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“…The patient characteristics and study procedures are described in detail elsewhere [10], [11]. Information relevant to the present study is briefly described below.…”

Section: Methodsmentioning

confidence: 99%

Patient-Specific Oscillometric Blood Pressure Measurement

Liu

Cheng²,

Chen³

et al. 2016

IEEE Trans. Biomed. Eng.

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Objective Most automatic cuff blood pressure (BP) measurement devices are based on oscillometry. These devices estimate BP from the envelopes of the cuff pressure oscillations using fixed ratios. The values of the fixed ratios represent population averages, so the devices may only be accurate in subjects with normal BP levels. The objective was to develop and demonstrate the validity of a patient-specific oscillometric BP measurement method. Methods The idea of the developed method was to represent the cuff pressure oscillation envelopes with a physiologic model and then estimate the patient-specific parameters of the model, which includes BP levels, by optimally fitting it to the envelopes. The method was investigated against gold standard reference BP measurements from 57 patients with widely varying pulse pressures. A portion of the data was used to optimize the patient-specific method and a fixed-ratio method, while the remaining data were used to test these methods and a current office device. Results The patient-specific method yielded BP root-mean-square-errors ranging from 6.0 to 9.3 mmHg. On average, these errors were nearly 40% lower than the errors of each existing method. Conclusion The patient-specific method may improve automatic cuff BP measurement accuracy. Significance A patient-specific oscillometric BP measurement method was proposed and shown to be more accurate than the conventional method and a current device.

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“…PWA is more specific for the individual patient than the method using GTF for estimating CBP [25]. The GTF is based on population average and does not take into account individual characteristics such as age, gender, and disease status.…”

Section: Pulse Wave Analysis Versus Gtfmentioning

confidence: 99%

“…In addition, some GTF-based devices calculate cPP by subtracting cuff DBP from cSBP because clinical evidence showed that central DBP does not significantly differ from peripheral DBP [19]. However, calculating cPP this way appears to be less accurate than the directly assessed cPP by means of PWA as the GTF-based method bears measurement errors for both cuff SBP and DBP [25]. …”

Section: Pulse Wave Analysis Versus Gtfmentioning

confidence: 99%

Practical Suitability of a Stand-Alone Oscillometric Central Blood Pressure Monitor: A Review of the Microlife WatchBP Office Central

Verberk

Cheng

Huang³

et al. 2015

Pulse

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Accumulating evidence indicates that central blood pressure (CBP) is a better cardiovascular risk predictor than brachial blood pressure (BP). Although more additional benefits of CBP-based treatment above usual hypertension treatment are to be demonstrated, the demand for implementing CBP assessment in general clinical practice is increasing. For this, the measurement procedure must be noninvasive, easy to perform, and cost- and time-efficient. Therefore, oscillometric devices with the possibility to assess CBP seem the best option. Recently, such an oscillometric BP monitor, the Microlife WatchBP Office Central, was developed, which demonstrated its high accuracy in a validation study against invasive BP measurement. Calibration errors of this device are limited because the procedure is automated, standardized, and performed at the same place of and within 30 s from pulse wave assessment. The transformation from the peripheral pulse wave to CBP is done by means of an individual-based pulse wave analysis according to a theory of arterial compliance and wave reflections. In addition, the device has demonstrated to enable a more reliable diagnosis of hypertension by CBP than by peripheral BP, with a lower frequency of over- and underdiagnosis. Altogether, the available clinical evidence suggests that the Microlife WatchBP Office Central fulfills the criteria for general clinical use.

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Measurement of Central Aortic Pulse Pressure: Noninvasive Brachial Cuff-Based Estimation by a Transfer Function Vs. a Novel Pulse Wave Analysis Method

Abstract: Large random and systematic errors are introduced into the PP-C estimates when PP-C is calculated as the difference between the estimated central SBP and central or cuff DBP. The accuracy can be improved substantially with the novel PWA approach.

Cited by 27 publications

References 37 publications

Reliability assessment for pulse wave measurement using artificial pulse generator

Reliability assessment for pulse wave measurement using artificial pulse generator

Patient-Specific Oscillometric Blood Pressure Measurement

Practical Suitability of a Stand-Alone Oscillometric Central Blood Pressure Monitor: A Review of the Microlife WatchBP Office Central

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