TY - JOUR
T1 - Determination of central blood pressure by a noninvasive method (brachial BP and QKD interval)
AU - Cremer, Antoine
AU - Butlin, Mark
AU - Codjo, Léopold
AU - Coulon, Paul
AU - Ranouil, Xavier
AU - Joret, Cédric
AU - Coste, Pierre
AU - Asmar, Roland
AU - Avolio, Alberto
AU - Gosse, Philippe
PY - 2012/8
Y1 - 2012/8
N2 - Background: The measurement of central blood pressure (BPc) has become a matter of importance. Several therapeutic trials have noted a different protective effect against cardiovascular complications with different antihypertensive strategies, but an identical decrease in brachial BP (BPb). A possible explanation lies in the different effects of the treatments on BPc. We propose a new noninvasive method for the automatic measurement of BPc based on the QKD interval, an arterial stiffness marker. Materials and Methods: This study was carried out on patients referred for cardiac catheterization. We simultaneously measured the central SBP (SBPc) invasively with a pigtail probe, and the BPb by a cuff coupled with recording of the QKD interval. Two cohorts were studied, one to define an algorithm of SBPc estimation and one to validate this algorithm. Results: The first cohort included 65 patients. We performed 136 simultaneous measurements. In the multivariate analysis, four variables were significantly correlated with SBPc: mean BPb (mBPb), QKD, height and heart rate (HR) with the following regression equation: SBP = 105 + 1.29 × mBPb-0.39 × HR-0.30 × height-0.11 × QKDThis equation estimated 81% of the variance of the invasive SBPc±13mmHg. This algorithm was then tested in another cohort of 80 patients. Difference between measured and estimated SBPc was 2±14mmHg. Conclusion: This study showed that it is possible to estimate SBPc by simultaneous measurement of QKD and BPb. If further studies confirm these results, a noninvasive ambulatory method of monitoring of SBPc could be employed in clinical practice.
AB - Background: The measurement of central blood pressure (BPc) has become a matter of importance. Several therapeutic trials have noted a different protective effect against cardiovascular complications with different antihypertensive strategies, but an identical decrease in brachial BP (BPb). A possible explanation lies in the different effects of the treatments on BPc. We propose a new noninvasive method for the automatic measurement of BPc based on the QKD interval, an arterial stiffness marker. Materials and Methods: This study was carried out on patients referred for cardiac catheterization. We simultaneously measured the central SBP (SBPc) invasively with a pigtail probe, and the BPb by a cuff coupled with recording of the QKD interval. Two cohorts were studied, one to define an algorithm of SBPc estimation and one to validate this algorithm. Results: The first cohort included 65 patients. We performed 136 simultaneous measurements. In the multivariate analysis, four variables were significantly correlated with SBPc: mean BPb (mBPb), QKD, height and heart rate (HR) with the following regression equation: SBP = 105 + 1.29 × mBPb-0.39 × HR-0.30 × height-0.11 × QKDThis equation estimated 81% of the variance of the invasive SBPc±13mmHg. This algorithm was then tested in another cohort of 80 patients. Difference between measured and estimated SBPc was 2±14mmHg. Conclusion: This study showed that it is possible to estimate SBPc by simultaneous measurement of QKD and BPb. If further studies confirm these results, a noninvasive ambulatory method of monitoring of SBPc could be employed in clinical practice.
UR - http://www.scopus.com/inward/record.url?scp=84863816080&partnerID=8YFLogxK
U2 - 10.1097/HJH.0b013e328354dd26
DO - 10.1097/HJH.0b013e328354dd26
M3 - Article
C2 - 22688261
AN - SCOPUS:84863816080
VL - 30
SP - 1533
EP - 1539
JO - Journal of Hypertension
JF - Journal of Hypertension
SN - 1473-5598
IS - 8
ER -