Validation of a method for noninvasive measurement of central arterial pressure.
The goal of this study was to validate a newly improved noninvasive method for calibrated measurement of the ascending portion of the central arterial pressure wave in humans. Noninvasive pressure waveforms were generated by measuring the time delay between the R wave of the electrocardiogram and onset of brachial artery flow (by Doppler) during computer-controlled upper arm cuff deflation. This delay shortens with falling cuff pressure (becoming near constant at and below diastolic pressure), so that a plot of pressure versus time delay yields the ascending portion of the arterial waveform. These waveforms were compared with simultaneous invasive ascending aortic pressures in 57 adult patients (31 by fluid manometer [group A] and 26 by catheter-tipped micromanometer [group B]) during routine cardiac catheterization. Patient age ranged from 26 to 77 years. Eighty percent of group A patients and 40% of group B had coronary artery disease. Noninvasive systolic and diastolic pressures were very similar to invasive values in both groups (Pni = 0.98 x Pi, r = 0.99, p < 0.0001). Instantaneous pressure differences between waveforms were also similar in both groups, averaging between 4.5 and 5.5 mm Hg. Micromanometer and noninvasive pressure data were also obtained before and after intravenous nitroglycerin (n = 5) and isometric handgrip (n = 8) and demonstrated good agreement. A potential application of these pressures is for estimating maximal ventricular power to assess systolic function. This was tested using invasive pressure-volume data from four patients under a variety of conditions (exercise, pacing, etc.).(ABSTRACT TRUNCATED AT 250 WORDS)
Sharir
T
T
Department of Internal Medicine, Johns Hopkins Medical Institutions, Baltimore, Md.
Marmor
A
A
Ting
C T
CT
Chen
J W
JW
Liu
C P
CP
Chang
M S
MS
Yin
F C
FC
Kass
D A
DA
D000328:Adult; D000368:Aged; D001011:Aorta / Q000502:physiology*; D001783:Blood Flow Velocity; D001794:Blood Pressure / Q000187:drug effects; D001795:Blood Pressure Determination / Q000379:methods*; D002138:Calibration; D006328:Cardiac Catheterization; D003936:Diagnosis, Computer-Assisted; D004562:Electrocardiography; D006801:Humans; D008875:Middle Aged; D005996:Nitroglycerin / Q000494:pharmacology
D005996:Nitroglycerin