BACKGROUND:Central arterial pressure is a better predictor of adverse cardiovascular outcomes than brachial blood pressure, but noninvasive measurement by applanation tonometry is technically demanding. METHOD:Pulsecor R6.5 is a novel device adapted from a standard sphygmomanometer which estimates the central aortic pressure from analysis of low-frequency suprasystolic waveforms at the occluded brachial artery. A physics-based model, which simulates the arterial system using elastic, thin-walled tube elements and Navier-Stokes equations, is used to calculate arterial pressure and flow propagation. To determine the reliability of the device, we compared 94 central systolic pressures estimated by Pulsecor to the simultaneous directly measured central aortic pressures at the time of coronary angiography in 37 individuals. RESULTS:There was good correlation in central SBP between catheter measurements and Pulsecor estimates by either invasive or noninvasive calibration methods (r = 0.99, P < 0.0001 and r = 0.95, P < 0.0001, respectively). The mean difference in central systolic pressure was 2.78 (SD 3.90) mmHg and coefficient of variation was 0.03 when the invasive calibration method was used.When the noninvasive calibration method was used, the mean difference in central systolic pressure was 0.25 (SD 6.31) mmHg and coefficient of variation was 0.05. CONCLUSION:We concluded that Pulsecor R6.5 provides a simple and easy method to noninvasively estimate central SBP, which has highly acceptable accuracy.

译文

背景:与肱动脉血压相比,中央动脉压是心血管不良预后的更好预测指标,但是压平眼压计的无创测量在技术上要求很高。
方法:Pulsecor R6.5是一种采用标准血压计的新型装置,该血压计通过分析闭塞的肱动脉的超搏动上的波形来估计中心主动脉压。基于物理的模型使用弹性薄壁管元件和Navier-Stokes方程模拟动脉系统,用于计算动脉压力和流量传播。为了确定设备的可靠性,我们比较了Pulsecor估计的94例中心收缩压与37例冠状动脉造影时同时直接测量的中心主动脉压。
结果:通过有创或无创校准方法,导管测量值与Pulsecor估计之间的中央SBP均具有良好的相关性(分别为r = 0.99,P <0.0001和r = 0.95,P <0.0001)。使用有创校准方法时,收缩压的中心平均差异为2.78(SD 3.90)mmHg,使用无创校准法时的变异系数为0.03;使用无创校准方法时,收缩压的平均差异为0.25(SD 6.31)mmHg。变异系数为0.05。
结论:我们得出结论,Pulsecor R6.5提供了一种简单且简便的方法来无创地估计中心性SBP,其准确度非常高。

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