Pre Ejection Period - PEP As Measure For The Inotropic Status Of The Heart

Cuffless Estimation of Systolic Blood Pressure for Short Effort Bicycle Tests: The Prominent Role of the Pre-Ejection Period

“…In these models the characteristics of the arterial tonus, inherently modelled by the coefficients and E 0 , affect the fitting parameters. However, blood pressure is regulated by at least four other factors representing the patient's cardio-vascular status: 1. the cardiac output, 2. the rate of ventricle contractility related to systolic intervals PEP & LVET (left ventricle ejection time) [9], 3. the total peripheral resistance (TPR) [9,11] and 4. the return of venous blood insuring the filling of the right ventricle and determining the cardiac preload. Most of these factors are often assumed to be constant under well-defined conditions, typically at rest.…”

“…For the most popular sensor configuration with an ECG as proximal signal and a photoplethysmographic (PPG) sensor located at a peripheral site like the finger, we clarify the specific roles of the pre-ejection period (PEP) and PTT of relevance for interpreting the actually measured pulse arrival time (PAT). This time is defined as the time-delay between the R-peak of the QRS wave from the ECG and the arrival of the arterial pulse wave at the periphery and comprises the sum of PEP and PTT, both representing different underlying cardio-vascular mechanisms [5][6][7]9,10]. Based on data gathered in a trial with healthy volunteers performing a short physical effort test we investigated the relationship of PEP and PTT and evaluated several strategies for systolic blood pressure estimation via PAT measurements.…”