Key result
A novel method using peripheral blood pressure waveforms estimated forward and backward pressure waves with a root-mean-squared error of <5 mmHg compared to actual waves in cardiac surgery patients.
Why the study?
Does a novel method using peripheral blood pressure waveforms accurately quantify blood pressure wave reflection compared to invasive central aortic measurements in a swine model and cardiac surgery patients?
Does a novel method using peripheral blood pressure waveforms accurately quantify blood pressure wave reflection compared to invasive central aortic measurements in a swine model and cardiac surgery patients?
A novel method using peripheral blood pressure waveforms can accurately estimate central aortic wave reflection without requiring highly invasive central aortic measurements or characteristic impedance estimation.
Supports non-invasive wave reflection estimation in cardiac surgery; leaves open validation and outcome impact in broader populations.
This paper presents a novel minimally invasive method for quantifying blood pressure (BP) wave reflection in the arterial tree. In this method, two peripheral BP waveforms are analyzed to obtain an estimate of central aortic BP waveform, which is used together with a peripheral BP waveform to compute forward and backward pressure waves. These forward and backward waves are then used to quantify the strength of wave reflection in the arterial tree. Two unique strengths of the proposed method are that 1) it replaces highly invasive central aortic BP and flow waveforms required in many existing methods by less invasive peripheral BP waveforms, and 2) it does not require estimation of characteristic impedance. The feasibility of the proposed method was examined in an experimental swine subject under a wide range of physiologic states and in 13 cardiac surgery patients. In the swine subject, the method was comparable to the reference method based on central aortic BP and flow. In cardiac surgery patients, the method was able to estimate forward and backward pressure waves in the absence of any central aortic waveforms: on the average, the root-mean-squared error between actual versus computed forward and backward pressure waves was less than 5 mmHg, and the error between actual versus computed reflection index was less than 0.03.
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Kim et al. (2014) studied Cardiac surgery (n=13). Novel minimally invasive method using two peripheral BP waveforms vs. Reference method based on central aortic BP and flow was evaluated on Root-mean-squared error between actual versus computed forward and backward pressure waves, and error between actual versus computed reflection index. A novel method using peripheral blood pressure waveforms estimated forward and backward pressure waves with a root-mean-squared error of <5 mmHg compared to actual waves in cardiac surgery patients.
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