Non-Invasive Estimation of Central Systolic Blood Pressure by Radial Tonometry: A Simplified Approach

Chemla, Denis; Agnoletti, Davide; Jozwiak, Mathieu; Zhang, Yi; Protogerou, Athanase D.; Millasseau, Sandrine; Blacher, Jacques

doi:10.3390/jpm13081244

Cited by 3 publications

(2 citation statements)

References 30 publications

(44 reference statements)

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“…A notable novelty of the study is its exploration of DCBP's accuracy and precision in relation to prevailing aoSBP levels. The pressure-dependent errors documented by the authors at the brachial level ( 2 ) have not been observed at the aortic or radial levels ( 1 , 17 ), suggesting the necessity for additional explanation and confirmation. The authors have addressed some limitations of the study, but there are a few other important ones that also require consideration.…”

Section: Strengths and Limitations Of The Current Studymentioning

confidence: 77%

“…At that point, one may ask how DCBP compares to non-invasive tonometry-derived aoSBP? To answer this question, our group recently conducted a non-invasive study on 160 patients using radial applanation tonometry with the SphygmoCor calibrated on brachial SBP/DBP ( 17 ). The time-averaged MBP was calculated from the radial pulse waveform.…”

Section: Further Researchmentioning

confidence: 99%

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Commentary: Direct estimation of central aortic pressure from measured or quantified mean and diastolic brachial blood pressure: agreement with invasive records

Chemla,

Jozwiak

2023

Front. Cardiovasc. Med.

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Section: Strengths and Limitations Of The Current Studymentioning

confidence: 77%

Section: Further Researchmentioning

confidence: 99%

Commentary: Direct estimation of central aortic pressure from measured or quantified mean and diastolic brachial blood pressure: agreement with invasive records

Chemla,

Jozwiak

2023

Front. Cardiovasc. Med.

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Assessing the Accuracy of Systolic Aortic Pressure Estimation From a Brachial Cuff Alone: A Comparison With Radial Tonometry

Chemla,

Agnoletti,

Attal

et al. 2024

American Journal of Hypertension

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BACKGROUND A novel method for estimating central systolic aortic pressure (cSAP) has emerged, relying solely on the peripheral mean (MBP) and diastolic (DBP) blood pressures. We aimed to assess the accuracy of this Direct Central Blood Pressure estimation using cuff alone (DCBPcuff = MBP2/DBP) in comparison to the use of a generalized transfer function to derive cSAP from radial tonometry (cSAPtono). METHODS This retrospective analysis involved the International Database of Central Arterial Properties for Risk Stratification (IDCARS) data (Aparicio et al., Am J Hypertens 2022). The dataset encompassed 10,930 subjects from 13 longitudinal cohort studies worldwide (54.8% women; median age 46.0 years; office hypertension: 40.1%; treated: 61.0%), documenting cSAPtono via SphygmoCor calibrated against brachial systolic BP (SBP) and DBP. Our analysis focused on aggregate group data from 12/13 studies (89% patients) where a full BP dataset was available. A 35% form factor was used to estimate MBP = (DBP + (0.35 × (SBP-DBP)), from which DCBPcuff was derived. The predefined acceptable error for cSAPtono estimation was set at ≤ 5 mm Hg. RESULTS The cSAPtono values ranged from 103.8–127.0 mm Hg (n = 12). The error between DCBPcuff and cSAPtono was 0.2 ± 1.4 mm Hg, with no influence of the mean. Errors ranged from −1.8 to 2.9 mm Hg across studies. No significant difference in errors was observed between BP measurements obtained via oscillometry (n = 9) vs. auscultation (n = 3) (P = 0.50). CONCLUSIONS Using published aggregate group data and a 35% form factor, DCBPcuff demonstrated remarkable accuracy in estimating cSAPtono, regardless of the BP measurement technique. However, given that individual BP values were unavailable, further documentation is required to establish DCBPcuff’s precision.

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Estimation of central blood pressure waveform from femoral blood pressure waveform by blind sources separation

Gbaoui,

Hoeschen,

Kaniusas

et al. 2023

Front. Cardiovasc. Med.

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BackgroundCentral blood pressure (cBP) is a better indicator of cardiovascular morbidity and mortality than peripheral BP (pBP). However, direct cBP measurement requires invasive techniques and indirect cBP measurement is based on rigid and empirical transfer functions applied to pBP. Thus, development of a personalized and well-validated method for non-invasive derivation of cBP from pBP is necessary to facilitate the clinical routine. The purpose of the present study was to develop a novel blind source separation tool to separate a single recording of pBP into their pressure waveforms composing its dynamics, to identify the compounds that lead to pressure waveform distortion at the periphery, and to estimate the cBP. The approach is patient-specific and extracts the underlying blind pressure waveforms in pBP without additional brachial cuff calibration or any a priori assumption on the arterial model.MethodsThe intra-arterial femoral BPfe and intra-aortic pressure BPao were anonymized digital recordings from previous routine cardiac catheterizations of eight patients at the German Heart Centre Berlin. The underlying pressure waveforms in BPfe were extracted by the single-channel independent component analysis (SCICA). The accuracy of the SCICA model to estimate the whole cBP waveform was evaluated by the mean absolute error (MAE), the root mean square error (RMSE), the relative RMSE (RRMSE), and the intraclass correlation coefficient (ICC). The agreement between the intra-aortic and estimated parameters including systolic (SBP), diastolic (DBP), mean arterial pressure (MAP), and pulse pressure (PP) was evaluated by the regression and Bland–Altman analyses.ResultsThe SCICA tool estimated the cBP waveform non-invasively from the intra-arterial BPfe with an MAE of 0.159 ± 1.629, an RMSE of 5.153 ± 0.957 mmHg, an RRMSE of 5.424 ± 1.304%, and an ICC of 0.94, as well as two waveforms contributing to morphological distortion at the femoral artery. The regression analysis showed a strong linear trend between the estimated and intra-aortic SBP, DBP, MAP, and PP with high coefficient of determination R2 of 0.98, 0.99, 0.99, and 0.97 respectively. The Bland–Altman plots demonstrated good agreement between estimated and intra-aortic parameters with a mean error and a standard deviation of difference of −0.54 ± 2.42 mmHg [95% confidence interval (CI): −5.28 to 4.20] for SBP, −1.97 ± 1.62 mmHg (95% CI: −5.14 to 1.20) for DBP, −1.49 ± 1.40 mmHg (95% CI: −4.25 to 1.26) for MAP, and 1.43 ± 2.79 mmHg (95% CI: −4.03 to 6.90) for PP.ConclusionsThe SCICA approach is a powerful tool that identifies sources contributing to morphological distortion at peripheral arteries and estimates cBP.

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Non-Invasive Estimation of Central Systolic Blood Pressure by Radial Tonometry: A Simplified Approach

Cited by 3 publications

References 30 publications

Commentary: Direct estimation of central aortic pressure from measured or quantified mean and diastolic brachial blood pressure: agreement with invasive records

Commentary: Direct estimation of central aortic pressure from measured or quantified mean and diastolic brachial blood pressure: agreement with invasive records

Assessing the Accuracy of Systolic Aortic Pressure Estimation From a Brachial Cuff Alone: A Comparison With Radial Tonometry

Estimation of central blood pressure waveform from femoral blood pressure waveform by blind sources separation

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