Assessment of central arterial hemodynamics in children: comparison of non-invasive and invasive measurements

Tommy Y. Cai, Marjan M. Haghighi, Philip A. Roberts, Jonathan Mervis, Ahmad Qasem, Mark Butlin, David S. Celermajer, Alberto Avolio, Michael R. Skilton, Julian G. Ayer

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)

Abstract

Background: In adults, central systolic blood pressure (cSBP) and augmentation index (cAIx) are independently associated with cardiovascular events and mortality. There is increasing interest in central hemodynamic indices in children. We aimed to assess the accuracy of current techniques against invasive intra-aortic measurements in children.

Methods: Intra-aortic pressure waveforms were recorded with simultaneous brachial, radial, and carotid waveforms in 29 children (6.7 ± 3.9 years old) undergoing cardiac catheterization. Adult and age-appropriate transfer functions (TFs) (brachial adult: b-aTF; radial adult: r-aTF; radial for 8-year-old children: TF8; and radial for 14-year-old children: TF14) were used to synthesize central aortic waveforms from peripheral waveforms calibrated either to invasively or noninvasively recorded BP. Central hemodynamic indices were measured by pulse wave analysis.

Results: cSBP measured from invasively calibrated r-aTF (β = 0.84; intraclass correlation coefficient = 0.91; mean error ± SDD = -1.0 ± 5.0 mm Hg), TF8 (β = 0.78; intraclass correlation coefficient = 0.84; mean error ± SDD = 4.4 ± 5.6 mm Hg), and TF14 (β = 0.82; intraclass correlation coefficient = 0.90; mean error ± SDD = 2.0 ± 4.7 mm Hg)-synthesized central waveforms correlated with and accurately estimated intra-aortic cSBP measurements, while noninvasively calibrated waveforms did not. cAIx derived from TF-synthesized central waveforms did not correlate with intra-aortic cAIx values, and degree of error was TF-dependent.

Conclusions: The currently available r-aTF accurately estimates cSBP with invasive pulse pressure calibration, while. Age-appropriate TFs do not appear to provide additional benefit. Accuracy of cAIx estimation appears to be TF dependent.

Original languageEnglish
Pages (from-to)163-171
Number of pages9
JournalAmerican Journal of Hypertension
Volume34
Issue number2
DOIs
Publication statusPublished - 11 Mar 2021

Keywords

  • augmentation index
  • blood pressure
  • central arterial hemodynamics
  • central blood pressure
  • hypertension
  • pediatrics

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