title: Subject-specific estimation of central aortic blood pressure via system identification: preliminary in-human experimental study.
abstract: This paper demonstrates preliminary in-human validity of a novel subject-specific approach to estimation of central aortic blood pressure (CABP) from peripheral circulatory waveforms. In this "Individualized Transfer Function" (ITF) approach, CABP is estimated in two steps. First, the circulatory dynamics of the cardiovascular system are determined via model-based system identification, in which an arterial tree model is characterized based on the circulatory waveform signals measured at the body's extremity locations. Second, CABP waveform is estimated by de-convolving peripheral circulatory waveforms from the arterial tree model. The validity of the ITF approach was demonstrated using experimental data collected from 13 cardiac surgery patients. Compared with the invasive peripheral blood pressure (BP) measurements, the ITF approach yielded significant reduction in errors associated with the estimation of CABP, including 1.9-2.6 mmHg (34-42 %) reduction in BP waveform errors (p < 0.05) as well as 5.8-9.1 mmHg (67-76 %) and 6.0-9.7 mmHg (78-85 %) reductions in systolic and pulse pressure (SP and PP) errors (p < 0.05). It also showed modest but significant improvement over the generalized transfer function approach, including 0.1 mmHg (2.6 %) reduction in BP waveform errors as well as 0.7 (20 %) and 5.0 mmHg (75 %) reductions in SP and PP errors (p < 0.05).
authors.affiliation: Mechanical Engineering, University of Maryland, College Park, USA.
authors.forename: Nima
authors.initials: N
authors.lastname: Fazeli
authors.forename: Chang-Sei
authors.initials: CS
authors.lastname: Kim
authors.forename: Mohammad
authors.initials: M
authors.lastname: Rashedi
authors.forename: Alyssa
authors.initials: A
authors.lastname: Chappell
authors.forename: Shaohua
authors.initials: S
authors.lastname: Wang
authors.forename: Roderick
authors.initials: R
authors.lastname: MacArthur
authors.forename: M Sean
authors.initials: MS
authors.lastname: McMurtry
authors.forename: Barry
authors.initials: B
authors.lastname: Finegan
authors.forename: Jin-Oh
authors.initials: JO
authors.lastname: Hahn
mesh_terms: D000368:Aged; D000465:Algorithms; D001011:Aorta / Q000502:physiology*; D001794:Blood Pressure / Q000502:physiology*; D001795:Blood Pressure Determination / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008955:Models, Cardiovascular; D015203:Reproducibility of Results