Transmission of calibration errors (input) by generalized transfer functions to the aortic pressures (output) at different hemodynamic states

Papaioannou, Theodore G.; Lekakis, John; Karatzis, Emmanouil; Papamichael, Christos; Stamatelopoulos, Kimon; Protogerou, Athanase D.; Mavrikakis, Myron; Stefanadis, Christodoulos

doi:10.1016/j.ijcard.2005.07.014

Cited by 58 publications

(33 citation statements)

References 33 publications

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“…Such pressure errors can be 'transferred' by the Central pressure comparison by three devices M Rezai et al transfer function to cSBP estimates. 5,31 In line with the first explanation, our results show that when more accurate estimates of peripheral pressures are used to calibrate SC (that is, method 3), [20][21][22] the cSBP estimates are significantly higher, and less or not different from the two newer devices. Given the evidence on SC's traditional calibration, the relatively higher cSBPs by the two new devices and that from SC calibrated here by method 3 are likely to be closer to real.…”

Section: Discussionsupporting

confidence: 85%

Calibration mode influences central blood pressure differences between SphygmoCor and two newer devices, the Arteriograph and Omron HEM-9000

et al. 2011

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The objective of this study was to compare central systolic blood pressure (cSBP) and augmentation index (AIx) from two recently introduced devices, Omron HEM-9000 (OM) and Arteriograph (AG), not using a transfer function with those of the widely used SphygmoCor (SC) calibrated on brachial blood pressure like OM. Random-order manufacturer-recommended measurements using SC and OM by radial tonometry and AG were taken on the left arm in 35 men (54±10 years) after 5 min supine rest. Results are means (95% confidence interval) of differences using paired t-tests. cSBP by OM was 4.1 (1.0-7.1) mm Hg higher than by AG. Both OM and AG estimated the mean cSBP to be significantly higher than did SC (114.8 mm Hg) by 12.5 (10.3-14.7) and 8.6 (4.9-12.3) mm Hg, respectively, although closely correlating with SC (r¼0.9). Calibrating SC with diastolic blood pressure (DBP) and more accurate mean arterial pressure (as DBP+0.4ÂPP) resulted in significantly higher cSBP statistically not different from AG's cSBP: 0.9 (À1.1 to +2.9)mm Hg, and closer to OM's: 5.1 (3.4-6.8)mm Hg. Radial AIx from SC and OM disagreed by 3 (0.7-5.4)%, and correlated (r¼0.8) with AG's brachial AIx. AG's aortic AIx was 7.9 (5.7-10.2)% higher than SC's, but closely correlated (r¼0.9). Clinically significant, higher cSBP measured by AG, OM and more accurately calibrated SC adds to previous data suggesting that SC measurements by classic calibration underestimate cSBP. Invasive studies involving all three devices would be more illuminating. INTRODUCTIONCentral blood pressure (cSBP) and indices of wave reflections have become relevant to cardiovascular risk stratification and hypertension management. The primary organs targeted by hypertensive damage (heart, brain and kidneys) may be exposed more closely to aortic blood pressure (BP) and pulsations rather than that estimated by traditionally measured brachial pressures. 1 Moreover, antihypertensive medications may affect central and peripheral pressures differently 2 which could influence drug efficacy and risk reduction. 3 Our previous data from the CAFE study suggested that one drug class and combination produced greater central but not peripheral BP change based on SphygmoCor (SC). 2 There are still few large cohort studies comparing the prospective value of central versus peripheral (brachial) pressures, but a number of small to medium size studies have demonstrated the value of invasively measured central systolic and pulsating pressures prospectively. 4 Large trials demand quick non-invasive measurement of central pressures.

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Section: Discussionsupporting

confidence: 85%

Calibration mode influences central blood pressure differences between SphygmoCor and two newer devices, the Arteriograph and Omron HEM-9000

et al. 2011

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“…22 Moreover, this output error may be magnified by the GTF in the setting of slower heart rates and higher BPs. 23 As a consequence, the assessed central PP is usually underestimated. 20,22,24,25 The second method assesses systolic BP in the common carotid artery as a surrogate for the pressure in the ascending aorta.…”

Section: Assessment and Expression Of Pulse Pressure Amplification Inmentioning

confidence: 99%

Role of Pulse Pressure Amplification in Arterial Hypertension

et al. 2009

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“…When central BP waveforms are calibrated by brachial cuff pressures, the SphygmoCor approach might underestimate central SBP, in particular, at high levels of SBP. [25][26] However, pressure amplification, when expressed as the ratio of peripheral divided by central pulse pressure, should be independent of possible calibration errors. 27 As shown in the Supplementary Table available online, pressure amplification ratio (peripheral/central pulse pressure) consistently decreased with age in both cross-sectional and longitudinal analyses.…”

Section: Discussionmentioning

confidence: 99%

Age dependency of peripheral and central systolic blood pressures: cross-sectional and longitudinal observations in a Chinese population

Staessen

Sheng

et al. 2011

Hypertens Res

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Few studies have described the age-related changes in both peripheral and central systolic blood pressures (SBPs) in populations. We addressed this issue in 1066 women and 978 men, all untreated (mean age, 45.1 years; 27.2% hypertensive) and randomly selected from a Chinese population, of whom 369 and 330 underwent a repeat examination after 3.6 years (median). In cross-sectional analyses, central SBP increased more with age than peripheral SBP in women below age 50 (1.21 vs. 1.01 mm Hg per year; Po0.001) and in men below age 60 (0.73 vs. 0.48 mm Hg per year; Po0.001), whereas in older women (0.64 vs. 0.58 mm Hg per year; P¼0.27) and older men (0.45 vs. 0.44 mm Hg per year; P¼0.79), the slopes of central and peripheral SBPs on age were similar. Compared with men, women had steeper (Po0.001) age-related increases in peripheral and central SBPs. Systolic augmentation pressure increased with age, but this increase was substantially smaller (Po0.0001) for peripheral than central augmentation (women, 0.086 vs. 0.45 mm Hg per year; men, 0.083 vs. 0.39 mm Hg per year). In multivariable-adjusted regression, age contributed X89.7% of the explained variance in peripheral and central SBPs. In longitudinal analyses, the annual percentage increases from baseline to follow-up in peripheral and central SBP were similar (PX0.76) in both women (2.14% vs. 2.16 % per year) and men (1.33% vs. 1.34 % per year; P-values for sex difference p0.044). In conclusion, in younger subjects assessed cross-sectionally, the age-related increase was larger for central than peripheral SBP, whereas the corresponding cross-sectional estimates in older subjects and the longitudinal estimates in all subjects showed similar age-related increases in central and peripheral SBP.

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Transmission of calibration errors (input) by generalized transfer functions to the aortic pressures (output) at different hemodynamic states

Cited by 58 publications

References 33 publications

Calibration mode influences central blood pressure differences between SphygmoCor and two newer devices, the Arteriograph and Omron HEM-9000

Calibration mode influences central blood pressure differences between SphygmoCor and two newer devices, the Arteriograph and Omron HEM-9000

Role of Pulse Pressure Amplification in Arterial Hypertension

Age dependency of peripheral and central systolic blood pressures: cross-sectional and longitudinal observations in a Chinese population

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