Med Biol Eng Comput - Aortic pressure wave reconstruction during exercise is improved by adaptive filtering: a pilot study.

Tópicos

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Resumo

Reconstruction of central aortic pressure from a peripheral measurement by a generalized transfer function (genTF) works well at rest and mild exercise at lower heart rates, but becomes less accurate during heavy exercise. Particularly, systolic and pulse pressure estimations deteriorate, thereby underestimating central pressure. We tested individualization of the TF (indTF) by adapting its resonance frequency at the various levels of exercise. In seven males (age 44-57) with coronary artery disease, central and peripheral pressures were measured simultaneously. The optimal resonance frequency was predicted from regression formulas using variables derived from the individual's peripheral pressure pulse, including a pulse contour estimation of cardiac output (pcCO). In addition, reconstructed pressures were calibrated to central mean and diastolic pressure at each exercise level. Using a genTF and without calibration, the error in estimated aortic pulse pressure was -7.5???6.4?mmHg, which was reduced to 0.2???5.7?mmHg with the indTFs using pcCO for prediction. Calibration resulted in less scatter at the cost of a small bias (2.7?mmHg). In exercise, the indTFs predict systolic and pulse pressure better than the genTF. This pilot study shows that it is possible to individualize the peripheral to aortic pressure transfer function, thereby improving accuracy in central blood pressure assessment during exercise.

Resumo Limpo

reconstruct central aortic pressur peripher measur general transfer function gentf work well rest mild exercis lower heart rate becom less accur heavi exercis particular systol puls pressur estim deterior therebi underestim central pressur test individu tf indtf adapt reson frequenc various level exercis seven male age coronari arteri diseas central peripher pressur measur simultan optim reson frequenc predict regress formula use variabl deriv individu peripher pressur puls includ puls contour estim cardiac output pcco addit reconstruct pressur calibr central mean diastol pressur exercis level use gentf without calibr error estim aortic puls pressur mmhg reduc mmhg indtf use pcco predict calibr result less scatter cost small bias mmhg exercis indtf predict systol puls pressur better gentf pilot studi show possibl individu peripher aortic pressur transfer function therebi improv accuraci central blood pressur assess exercis

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