title: The effects of pre-ejection period on post-exercise systolic blood pressure estimation using the pulse arrival time technique.
abstract: Pulse arrival time (PAT) is comprised of the vascular transit time (TT) through the arterial system and the pre-ejection period (PEP) in the heart. It has been used to predict arterial blood pressure (BP) without using a cuff. The aim of this study was to investigate the effects of including the PEP on the accuracy of cuffless systolic BP (SBP) estimation using the PAT technique in post-exercise recovery. Experiments were conducted on 22 normotensive participants. PAT, TT and PEP were determined from simultaneous measurements of the electrocardiogram, photoplethysmogram and impedance cardiogram. Moderate exercise induced significant (p < 0.05) increases in SBP and heart rate and significant (p < 0.05) decreases in PEP and PAT. Diastolic blood pressure and TT only varied insignificantly (p > 0.05). SBP was moderately correlated with PEP (r = -0.61) and PAT (r = -0.81). PAT and PEP were moderately correlated (r = 0.67). When SBP was estimated using least-squares methods, the differences between the measured and predicted SBP using PEP, PAT and TT were 0.0 ± 6.6, 0.0 ± 4.9 and 0.0 ± 9.3 mmHg, respectively. The findings suggested that PAT gives the best SBP prediction and PEP has some potential to predict blood pressure. The inclusion of PEP in the PAT measurement is necessary to facilitate accurate cuffless blood pressure prediction after exercise.
authors.affiliation: The Joint Research Centre for Biomedical Engineering, Electronic Engineering Department, The Chinese University of Hong Kong, Shatin, Hong Kong.
authors.forename: Mico Yee Man
authors.initials: MY
authors.lastname: Wong
authors.forename: Emma
authors.initials: E
authors.lastname: Pickwell-MacPherson
authors.forename: Yuan Ting
authors.initials: YT
authors.lastname: Zhang
authors.forename: Jack C Y
authors.initials: JC
authors.lastname: Cheng
mesh_terms: D000328:Adult; D001794:Blood Pressure / Q000502:physiology*; D001795:Blood Pressure Determination; D015444:Exercise / Q000502:physiology*; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D008297:Male; D008991:Monitoring, Physiologic
references.citation: J Clin Monit Comput. 1999 Dec;15(7-8):493-501
references.pmid: 12578047
references.citation: Conf Proc IEEE Eng Med Biol Soc. 2005;2005:5877-80
references.pmid: 17281597
references.citation: J Appl Physiol (1985). 2006 Jan;100(1):136-41
references.pmid: 16141378
references.citation: Br Heart J. 1978 Mar;40(3):268-75
references.pmid: 637980
references.citation: Psychophysiology. 1994 Nov;31(6):599-608
references.pmid: 7846220
references.citation: Med Biol Eng Comput. 2004 Sep;42(5):707-11
references.pmid: 15503973
references.citation: Blood Press Monit. 2001 Apr;6(2):107-10
references.pmid: 11433132
references.citation: Psychophysiology. 1981 May;18(3):316-21
references.pmid: 7291449
references.citation: Psychophysiology. 1983 Jan;20(1):45-9
references.pmid: 6828611
references.citation: Clin Cardiol. 1986 Nov;9(11):545-9
references.pmid: 3802602
references.citation: Psychophysiology. 1981 Jan;18(1):71-4
references.pmid: 7465731
references.citation: Blood Press Monit. 2002 Aug;7(4):237-41
references.pmid: 12198340
references.citation: Thorax. 1999 May;54(5):452-7
references.pmid: 10212114
references.citation: Psychophysiology. 1983 Jan;20(1):21-8
references.pmid: 6828608
references.citation: Eur J Appl Physiol. 2009 Sep;107(2):169-75
references.pmid: 19543907
references.citation: J Clin Anesth. 2000 Nov;12(7):509-18
references.pmid: 11137411
references.citation: Psychophysiology. 1994 Nov;31(6):586-98
references.pmid: 7846219
references.citation: Circulation. 1972 Sep;46(3):559-71
references.pmid: 4561119
references.citation: Psychophysiology. 1979 Nov;16(6):546-53
references.pmid: 229507
references.citation: Circulation. 1973 Mar;47(3):499-508
references.pmid: 4632502
references.citation: Psychophysiology. 1981 May;18(3):301-6
references.pmid: 6117101
references.citation: Ultrason Imaging. 1979 Oct;1(4):356-67
references.pmid: 575833
references.citation: Conf Proc IEEE Eng Med Biol Soc. 2006;2006:5088-92
references.pmid: 17946673