Central blood pressure can be validly assessed from radial pulse waveforms in growing children: a longitudinal study

Y. Cai, X. Cai, A. Qasem, C. Melki, M. Butlin, J. Ayer, S. O'Meagher, B. Toelle, G. Marks, A. Avolio, D. Cellermajer, M. Skilton

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    Abstract

    Background: Central blood pressure confers key prognostic information and can be accurately estimated from peripheral arterial waveforms using generalised transfer functions. However, factors that modify the accuracy of such transfer functions are poorly described. We sought to determine the factors that are associated with changes in the accuracy of individualised transfer functions during childhood, a period of marked somatic growth. Methods: We studied healthy children at age 8 and followed up at age 14 years (n=93) with radial and carotid pressure waveforms measured by applanation tonometry (SphygmoCor). Data at 8 years were used to develop individualised peripheral-to-central transfer functions using mathematical autoregressive modelling. These individualised transfer functions were then applied to the radial waveform of the same child at 14 years of age in order to estimate central blood pressure. We then assessed the error between predicted and measured central (carotid) systolic pressure and analysed which growth parameters influenced model accuracy. Results: Individual transfer functions derived at 8 years accurately predicted central systolic blood measured in the same individuals at 14 years (average error=1.9 mm Hg [SD 7.4]). The estimation error was strongly associated with changes in measured central systolic pressure (B=-0.58; p<0.0001) between ages 8 and 14, with weaker evidence for associations with changes in height (B=0.18; p=0.10) and resting heart rate (B=-0.20; p=0.06). Conclusions: Central blood pressure can be accurately estimated over time in growing children using an individualised transfer function. Growth parameters within an individual have limited impact on the modelling accuracy of such individual transfer functions.
    Original languageEnglish
    Article number22
    Pages (from-to)S123
    Number of pages1
    JournalHeart Lung and Circulation
    Volume24
    Issue numberSupplement 3
    DOIs
    Publication statusPublished - 2015
    Event63rd Cardiac Society of Australia and New Zealand Annual Scientific Meeting and the International Society for Heart Research, Australasian Section, Annual Scientific Meeting 2015 - Melbourne, Australia
    Duration: 13 Aug 201516 Aug 2015

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