Central blood pressure measurement in children: development and validation of a paediatric transfer function

Y. Cai, A. Qasem, C. Melki, M. Butlin, J. Ayer, J. Harmer, B. Toelle, G. Mark, A. Avolio, D. Cellermajer, M. Skilton

Research output: Contribution to journalMeeting abstractpeer-review

Abstract

Background: Central pressure is an important parameter for assessing cardiovascular load, and can be accurately estimated from the peripheral pulse in adults by using a validated generalised transfer function. This adult transfer function has not been validated for use in children, and currently there is no dedicated paediatric transfer function available.

We sought to determine the accuracy of the adult transfer function when applied in children, and subsequently develop and validate a paediatric transfer function, for the accurate prediction of central systolic blood pressure (cSBP) and central augmentation index (cAIx) in children.

Methods: We studied healthy, pre-pubescent 8-year-old children (n=218) with radial and carotid pressure waveforms, measured by applanation tonometry (SphygmoCor, AtCor). cSBP and cAIx were calculated from carotid waveforms calibrated to peripheral (brachial) mean and diastolic blood pressures. Data from the first 50 participants were used to develop the paediatric transfer function by mathematical autoregressive modelling, which was then tested in the remaining 168 participants.

Results: The adult transfer function underestimated cSBP by 5.7 mm Hg (SD 3.2), and overestimated cAIx by 24.5 (SD 10.4). The paediatric transfer function more closely predicted both cSBP (Δ=2.1 mm Hg [SD 3.4]) and cAIx (Δ=-8.7 [SD 10.9]). Using the paediatric transfer function, 80% and 100% of estimated cSBP fell within 5 and 10 mmHg, respectively, of their measured values.

Conclusions: The paediatric transfer function more accurately predicts cSBP and cAIx in children than the adult transfer function, allowing for clinically meaningful assessment of cSBP in children.
Original languageEnglish
Article number23
Pages (from-to)S124
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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