Tracking of the beat-to-beat blood pressure changes by the Caretaker physiological monitor against invasive central aortic measurement

Abstract

Objective There is an unmet need for noninvasive continuous blood pressure (BP) monitoring technologies in various clinical settings. Continuous and noninvasive central aortic BP monitoring is technically not feasible currently, but if realized, would provide more accurate and real-time global hemodynamic information than any form of peripheral arterial BP monitoring in an acute care setting. As part of our efforts to develop such, herein we examined the tracking correlation between noninvasivelyderived peripheral arterial BP by Caretaker device against invasively measured central aortic BP.Methods Beat-to-beat BP by Caretaker was recorded simultaneously with central aortic BP measured in patients undergoing cardiac catheterization. Pearson's correlation was also derived for SBP and DBP. A trend comparison analysis of the beat-to-beat BP change was performed using a four-quadrant plot analysis with the exclusion zones of 0.5 mmHg/s to determine concordance, (i.e. the direction of beat-to-beat changes in SBP and DBP).Results A total of 47 patients were included in the study. A total of 31 369 beats representing an average of 17.3 min of recording were used for analysis. The trend analysis yielded concordances of 84.4 and 83.5% for SBP and DBP, respectively. Respective correlations (Pearson's r) for SBP and DBP trends were 0.87 and 0.86 (P < 0.01). Tracking of beat-to-beat BP by Caretaker showed excellent concordance and correlation in the direction and the degree of BP change with central aortic BP, respectively. ConclusionThis study supports the satisfactory performance of the Caretaker device in continuous tracking of central aortic BP beat-to-beat BP and provides a basis to develop an algorithm for absolute central aortic BP estimation in the future.

Short-term blood pressure variability and brain functional network connectivity in older adults

“…Some studies suggest measuring BP from both arms for improved accuracy of cardiovascular risk ( Clark et al, 2012 ). Consistent with other recent studies on BPV and brain health ( Sible et al, 2022a , 2022b , 2022c ), we assessed BPV on a beat-to-beat scale using a device that has been validated with ultra-sensitive intra-arterial BP monitoring ( Biopac, 2019 ; Gratz et al, 2017 ; Kwon et al, 2022 ). However, the BPV field is emerging and gold standards in methodology are not yet fully established ( Parati et al, 2013 , 2018 ).…”

Short-term blood pressure variability is inversely related to regional amplitude of low frequency fluctuations in older and younger adults

“…However, our BP collection and BPV calculation methods are consistent with a recent study on BPV and cerebral perfusion [55] that used the same BP monitoring device and MRI scanner and similar study sample. Additionally, the BP monitoring device used has been validated with ultra-sensitive intra-arterial BP monitoring [3] , [13] , [24] .…”

The interactive effect of intra-beat and inter-beat blood pressure variability on neurodegeneration in older adults

“…Increased blood pressure variability (BPV) has emerged as a risk factor for stroke 1 , cerebral small vessel disease (CSVD) 2,3 , neurodegenerative disease 4 and dementia 5 , independent of average blood pressure. Various markers of BPV have been investigated in the literature including both visit-to-visit BPV and beat-to-beat BPV, with beat-to-beat BPV emerging as a valid 6,7 , high temporal resolution hemodynamic marker associated with cardiovascular function 8 , autonomic function 9 , and vascular aging 10 . Average real variability (ARV) derived from beat-to-beat blood pressure data is a reliable measure of inter-beat blood pressure variability that is less susceptible to outliers than other BPV metrics [11][12][13] .…”