Central arterial pressure, measured close to the heart, may be of more patho-physiological importance than conventional non-invasive cuff blood pressure. The technique of applanation tonometry using SphygmoCor has been proposed as a non-invasive method of estimating central pressure. This relies on mathematically derived generalized transfer functions, which have been previously validated using invasive peripheral pressure measurements. We compared simultaneous estimates of central aortic pressure using this technique with those measured directly during the routine diagnostic cardiac catheterization of 30 subjects (age range 27-84 years), half of whom were aged 65 years or more. This was done by applanating the left radial artery and recording the non-invasive brachial cuff blood pressure to generate a central aortic pressure estimate, using the SphygmoCor radial transfer function. The comparative results were analysed using Bland-Altman plots of mean difference. SphygmoCor, on average, underestimated systolic central arterial pressure by 13.3 mmHg and overestimated diastolic pressure by 11.5 mmHg. The results were similar in patients aged under and above 65 years. Furthermore, non-invasively measured brachial pressures were seen to give an overall closer estimate of the central arterial pressure than the SphygmoCor system. The transfer function has been validated from invasively measured arterial pressures and the current use by the system of non-invasive measures may explain the discrepancies. However, age, drugs and arterial disease would also be expected to play a role.

译文

:靠近心脏测得的中央动脉压可能比常规的非侵入式袖带血压更重要的病理生理意义。已经提出了使用SphygmoCor进行压平眼压术的技术,作为估计中心压力的一种非侵入性方法。这依赖于数学推导的广义传递函数,该函数先前已使用侵入性外周压力测量进行了验证。我们将使用该技术对主动脉中心压的同时估计与在30名受试者(年龄范围27-84岁)的常规诊断性心脏导管插入术中直接测量的估计值进行了比较,其中一半年龄在65岁以上。这是通过使用SphygmoCor径向传递函数,通过压平左radial动脉并记录非侵入性肱动脉袖套血压以生成中心主动脉压力估算值来完成的。使用均值差的Bland-Altman图分析比较结果。 SphygmoCor平均将收缩期中央动脉压低估了13.3 mmHg,将舒张压高估了11.5 mmHg。 65岁以下及以上的患者的结果相似。此外,与SphygmoCor系统相比,非侵入式测量的肱动脉压可以总体上估计中心动脉压。传递函数已通过有创测量的动脉压得到验证,无创测量系统的当前使用可能解释了这种差异。但是,年龄,毒品和动脉疾病也有望发挥作用。

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