Direct estimation of central aortic pressure from measured or quantified mean and diastolic brachial blood pressure: agreement with invasive records

Daniel Bia; Federico Salazar; Luis Cinca; Marcos Gutiérrez; Alvaro D. Facta; Yanina Zócalo; Alejandro Díaz

doi:10.3389/fcvm.2023.1207069

July 25, 2023SHILAP Revista de lepidopterologíaOpen Access

Direct estimation of central aortic pressure from measured or quantified mean and diastolic brachial blood pressure: agreement with invasive records

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Why the study?

It remained to be assessed how the method or equation used to obtain brachial mean blood pressure affects estimated aortic systolic blood pressure and its agreement with invasive records.

Does the method of determining brachial mean blood pressure affect the accuracy of non-invasive central aortic systolic blood pressure estimation compared to invasive measurement?

Key Points

To determine how different methods and mathematical equations used to obtain brachial mean blood pressure affect the accuracy of central aortic systolic pressure estimations compared to invasive catheterization.
Simultaneously measured brachial and aortic pressures invasively via catheterization and non-invasively via brachial oscillometry in N=89 subjects.
Estimated central aortic systolic blood pressure using seven approaches based on oscillometry-derived mean blood pressure and six calculated equations.
Evaluated agreement between invasive and non-invasive records using Bland-Altman analysis and concordance correlation coefficients.
Achieving accurate estimation (error <5 mmHg) of invasive central aortic systolic pressure depended on the specific equation used for brachial mean pressure and the underlying pressure level due to proportional error.
Oscillometric mean pressure or approaches incorporating heart rate adjustments or a form factor of approximately 40% (rather than the conventional 33%) provided the closest agreement with invasive measurements.

Structured PICO

Does the method of determining brachial mean blood pressure affect the accuracy of non-invasive central aortic systolic blood pressure estimation compared to invasive measurement?

P

Population

89 subjects undergoing simultaneous invasive (catheterization) and non-invasive (brachial oscillometry) blood pressure measurement

I

Intervention

Non-invasive estimation of central aortic systolic blood pressure (aoSBP) using 7 different methods (measured oscillometric and 6 calculated equations for mean blood pressure)

C

Comparator

Invasive aortic pressure recording via catheterization

O

Outcome

Agreement between invasive and estimated aoSBP (assessed via Concordance correlation coefficient and Bland-Altman Test)surrogate

Oscillometric mean blood pressure or equations using a ~40% form factor provide the most accurate non-invasive estimation of central aortic systolic pressure compared to invasive measurements.

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Implication

Does not support immediate changes to non-invasive aoSBP estimation; hypothesis-generating for optimal brachial MBP methods.

Abstract

Background: /bDBP. It remains to be assessed to what extent the method and/or equation used to obtain the bMBP levels considered in aoSBP calculation may affect the estimated aoSBP, and consequently the agreement with aoSBP invasively recorded. Methods: Brachial and aortic pressure were simultaneously obtained invasively (catheterization) and non-invasively (brachial oscillometry) in 89 subjects. aoSBP was quantified in seven different ways, using measured (oscillometry-derived) and calculated (six equations) mean blood pressure (MBP) levels. The agreement between invasive and estimated aoSBP was analyzed (Concordance correlation coefficient; Bland-Altman Test). Conclusions: /DBP" to (accurately) estimate (error <5 mmHg) invasive aoSBP depends on the method and equation considered to determine bMBP, and on the aoSBP levels (proportional error). Oscillometric bMBP and/or approaches that consider adjustments for heart rate or a form factor ∼40% (instead of the usual 33%) would be the best way to obtain the bMBP levels to be used to calculate aoSBP.

Discussion

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Cite This Study

Bia et al. (2023) studied this question.

synapsesocial.com/papers/69f29d471b51e2fbf01874ef https://doi.org/10.3389/fcvm.2023.1207069

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Direct estimation of central aortic pressure from measured or quantified mean and diastolic brachial blood pressure: agreement with invasive records

Key Points

Structured PICO

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Direct estimation of central aortic pressure from measured or quantified mean and diastolic brachial blood pressure: agreement with invasive records

Key Points

Structured PICO

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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