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Non-invasive measurement of reservoir pressure parameters from brachial-cuff blood pressure waveforms

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Reservoir pressure parameters [eg, reservoir pressure (RP) and excess pressure (XSP)] are biomarkers derived from blood pressure (BP) waveforms that have been shown to predict cardiovascular events independent of conventional cardiovascular risk markers. However, whether RP and XSP can be derived non-invasively from operator-independent cuff device measured brachial or central BP waveforms has never been examined. This study sought to achieve this by comparison of cuff reservoir pressure parameters with intra-aortic reservoir pressure parameters. 162 participants (aged 61 ± 10 years, 72% male) undergoing coronary angiography had the simultaneous measurement of cuff BP waveforms (via SphygmoCor XCEL, AtCor Medical) and intra-aortic BP waveforms (via fluid-filled catheter). RP and XSP derived from cuff acquired brachial and central BP waveforms were compared with intra-aortic measures. Concordance between brachial-cuff and intra-aortic measurement was moderate-to-good for RP peak (36 ± 11 vs 48 ± 14 mm Hg, P < 0.001; ICC 0.77, 95% CI: 0.71-0.82), and poor-to-moderate for XSP peak (28 ± 10 vs 24 ± 9 mm Hg, P < 0.001; ICC 0.49, 95% CI: 0.35-0.60). Concordance between central-cuff and intra-aortic measurement was moderate-to-good for RP peak (35 ± 9 vs 46 ± 14 mm Hg, P < 0.001; ICC 0.77, 95% CI: 0.70-0.82), but poor for XSP peak (12 ± 3 vs 24 ± 9 mm Hg, P < 0.001; ICC 0.12, 95% CI: -0.13 to 0.31). In conclusion, both brachial-cuff and central-cuff methods can reasonably estimate intra-aortic RP, whereas XSP can only be acceptably derived from brachial-cuff BP waveforms. This should enable widespread application to determine the clinical significance, but there is significant room for refinement of the method.

History

Publication title

Journal of Clinical Hypertension

Volume

20

Issue

12

Pagination

1703-1711

ISSN

1524-6175

Department/School

Menzies Institute for Medical Research

Publisher

Le Jacq Communications, Inc.

Place of publication

United States

Rights statement

This is the pre-peer reviewed version of the following article: Peng, X and Schultz, MG and Picone, DS and Dwyer, N and Black, JA and Roberts-Thomson, P and Sharman, JE, Non-invasive measurement of reservoir pressure parameters from brachial-cuff blood pressure waveforms, Journal of Clinical Hypertension, 20, (12) pp. 1703-1711 which has been published in final form at http://dx.doi.org/10.1111/jch.13411. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.

Repository Status

  • Open

Socio-economic Objectives

Clinical health not elsewhere classified

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