Key result
An exponential-linear function yielded optimal model fits for the arterial compliance curve with errors of 7.9±0.3% and 5.1±0.2% for tail-trimmed and lower half-trimmed oscillogram measurements.
Why the study?
Oscillogram modeling is a tool for advancing oscillometric blood pressure measurement, but the optimal functional form for the arterial compliance curve in a reduced oscillogram model had not been determined.
A three-parameter exponential-linear function provides an optimal and mathematically tractable form for the arterial compliance curve in reduced oscillogram models, potentially improving oscillometric BP measurement accuracy.
May refine oscillometric BP modeling via exponential-linear compliance curves; leaves open prospective validation before clinical adoption.
Objective: Oscillogram modeling is a powerful tool for understanding and advancing popular oscillometric blood pressure (BP) measurement. A reduced oscillogram model relating cuff pressure oscillation amplitude ( <tex-math notation="LaTeX">Δ O</tex-math> ) to external cuff pressure of the artery ( <tex-math notation="LaTeX">Pₑ</tex-math> ) is: <tex-math notation="LaTeX">Δ O\ (Pₑ) = k ∫ _Pd - Pₑ^Pₛ - Pₑ g(P)dP</tex-math> , where <tex-math notation="LaTeX">$g(P)$</tex-math> is the arterial compliance versus transmural pressure ( <tex-math notation="LaTeX">P</tex-math> ) curve, <tex-math notation="LaTeX">Pₛ</tex-math> and <tex-math notation="LaTeX">Pd</tex-math> are systolic and diastolic BP, and <tex-math notation="LaTeX">k</tex-math> is the reciprocal of the cuff compliance. The objective was to determine an optimal functional form for the arterial compliance curve. Methods: Eight prospective, three-parameter functions of the brachial artery compliance curve were compared. The study data included oscillometric arm cuff pressure waveforms and invasive brachial BP from 122 patients covering a 20-120 mmHg pulse pressure range. The oscillogram measurements were constructed from the cuff pressure waveforms. Reduced oscillogram models, inputted with measured systolic and diastolic BP and each parametric brachial artery compliance curve function, were optimally fitted to the oscillogram measurements in the least squares sense. Results: An exponential-linear function yielded as good or better model fits compared to the other functions, with errors of 7.9±0.3 and 5.1±0.2% for tail-trimmed and lower half-trimmed oscillogram measurements. Importantly, this function was also the most tractable mathematically. Conclusion: A three-parameter exponential-linear function is an optimal form for the arterial compliance curve in the reduced oscillogram model and may thus serve as the standard function for this model henceforth. Significance: The complete, reduced oscillogram model determined herein can potentially improve oscillometric BP measurement accuracy while advancing foundational knowledge.
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Dhamotharan et al. (2022) studied this question. Exponential-linear function vs. Other three-parameter functions was evaluated on Model fit error. An exponential-linear function yielded optimal model fits for the arterial compliance curve with errors of 7.9±0.3% and 5.1±0.2% for tail-trimmed and lower half-trimmed oscillogram measurements.
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