An adaptive transfer function for deriving the aortic pressure waveform from a peripheral artery pressure waveform.
We developed a new technique to mathematically transform a peripheral artery pressure (PAP) waveform distorted by wave reflections into the physiologically more relevant aortic pressure (AP) waveform. First, a transfer function relating PAP to AP is defined in terms of the unknown parameters of a parallel tube model of pressure and flow in the arterial tree. The parameters are then estimated from the measured PAP waveform along with a one-time measurement of the wave propagation delay time between the aorta and peripheral artery measurement site (which may be accomplished noninvasively) by exploiting preknowledge of aortic flow. Finally, the transfer function with its estimated parameters is applied to the measured waveform so as to derive the AP waveform. Thus, in contrast to the conventional generalized transfer function, the transfer function is able to adapt to the intersubject and temporal variability of the arterial tree. To demonstrate the feasibility of this adaptive transfer function technique, we performed experiments in 6 healthy dogs in which PAP and reference AP waveforms were simultaneously recorded during 12 different hemodynamic interventions. The AP waveforms derived by the technique showed agreement with the measured AP waveforms (overall total waveform, systolic pressure, and pulse pressure root mean square errors of 3.7, 4.3, and 3.4 mmHg, respectively) statistically superior to the unprocessed PAP waveforms (corresponding errors of 8.6, 17.1, and 20.3 mmHg) and the AP waveforms derived by two previously proposed transfer functions developed with a subset of the same canine data (corresponding errors of, on average, 5.0, 6.3, and 6.7 mmHg).
Dept. of Electrical and Computer Engineering, Michigan State University, East Lansing, MI 48824-1226, USA.
Gokul
G
Swamy
Da
D
Xu
N Bari
NB
Olivier
Ramakrishna
R
Mukkamala
D000818:Animals; D001011:Aorta / Q000187:drug effects / Q000502:physiology*; D001794:Blood Pressure / Q000187:drug effects; D001795:Blood Pressure Determination / Q000379:methods*; D002304:Cardiac Pacing, Artificial; D002317:Cardiovascular Agents / Q000494:pharmacology; D002339:Carotid Arteries / Q000187:drug effects / Q000502:physiology*; D003198:Computer Simulation; D004285:Dogs; D005240:Feasibility Studies; D005263:Femoral Artery / Q000187:drug effects / Q000502:physiology*; D006339:Heart Rate; D008955:Models, Cardiovascular; D011673:Pulsatile Flow; D012039:Regional Blood Flow; D015203:Reproducibility of Results; D012815:Signal Processing, Computer-Assisted
D002317:Cardiovascular Agents