title: Noninvasive Assessment of Carotid Pulse Pressure Values: An Accelerometric-Based Approach.
abstract: OBJECTIVE
  Central pulse pressure (cPP) is increasingly investigated as possible independent predictor of cardiovascular risk and carotid pulse pressure (carPP) can be used as a surrogate of cPP. Despite its importance, carPP measurement remains challenging in clinical practice. The aim of this study was to introduce a new easier-to-use method for noninvasive carPP evaluation based on the use of a MEMS accelerometer.
  
  
  METHODS
  carPP values (carPP(acc)) were obtained in 22 subjects (10 males, 47 ±17 years, hypertension: 50%) postprocessing and double integrating the accelerometric signals. carPP(acc) measurements were compared with tonometric assessments (carPP(ton)), and ultrasound-derived measurements (carPP(us)). Moreover, accelerometric carotid pressure waveforms (P(acc)) were contrasted in terms of shape to those obtained by tonometry (P(ton)) and ultrasound images elaboration (P(US)), calculating the root mean square error (RMSE(ton), RMSE(US)) and the regression coefficients (r(ton) and r(US)). Moreover, both the repeatability and reproducibility analyses were performed.
  
  
  RESULTS
  carPP(acc) values (45.9 ±10.6 mmHg) were significantly correlated with carPP(ton) (47.5 ±11.3 mmHg) and carPP(US) (43.3 ±8.4 mmHg) assessments (R = 0.94, p < 0.0001 and R = 0.80, p < 0.0001, respectively). The validity of the accelerometric approach was confirmed by morphological parameters ( RMSE(ton) = 5 ±1.95 mmHg, RMSE(US) = 5.5 ±2.3 mmHg, r(ton) = 0.94 ±0.04, r(US) = 0.93 ±0.04). Coefficient of variation (CV) was equal to 6.2% for the repeatability analysis, while CV values for interoperator and intersession reproducibilities were 8.9% and 9.4%, respectively.
  
  
  CONCLUSIONS
  The proposed approach, providing an easier and more available measurement, could represent a valid alternative to existing and used technique for carPP assessment.
authors.forename: Nicole
authors.initials: N
authors.lastname: Di Lascio
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Gemignani
authors.forename: Rosa Maria
authors.initials: RM
authors.lastname: Bruno
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Bianchini
authors.forename: Francesco
authors.initials: F
authors.lastname: Stea
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Ghiadoni
authors.forename: Francesco
authors.initials: F
authors.lastname: Faita
mesh_terms: D061725:Accelerometry / Q000295:instrumentation / Q000379:methods*; D000328:Adult; D001794:Blood Pressure / Q000502:physiology*; D001795:Blood Pressure Determination / Q000295:instrumentation / Q000379:methods*; D002339:Carotid Arteries / Q000502:physiology*; D004867:Equipment Design; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012815:Signal Processing, Computer-Assisted / Q000295:instrumentation*