Non-invasive assessment of local arterial pulse pressure: comparison of applanation tonometry and echo-tracking

Citation
Lm. Van Bortel et al., Non-invasive assessment of local arterial pulse pressure: comparison of applanation tonometry and echo-tracking, J HYPERTENS, 19(6), 2001, pp. 1037-1044
Citations number
27
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Cardiovascular & Respiratory Systems","Cardiovascular & Hematology Research
Journal title
JOURNAL OF HYPERTENSION
ISSN journal
0263-6352 → ACNP
Volume
19
Issue
6
Year of publication
2001
Pages
1037 - 1044
Database
ISI
SICI code
0263-6352(200106)19:6<1037:NAOLAP>2.0.ZU;2-7
Abstract
Objectives Pulse pressure is not constant throughout the arterial tree. Use of pulse pressure at one arterial site as surrogate for pulse pressure at another arterial site may be erroneous. The present study compares three no n-invasive techniques to measure local pulse pressure: (i) internally calib rated readings from applanation tonometry, (ii) alternative calibration of pressure waves obtained with applanation tonometry and (iii) alternative ca libration of arterial distension waves obtained with echo-tracking. Alterna tive calibration assumes mean and diastolic blood pressure constant through out the large artery tree. Design and methods Study 1 used invasive measurements in the ascending aort a as a reference method and internally calibrated tonometer readings and al ternatively calibrated pressure waves at the common carotid artery as test methods. Study 2 used alternatively calibrated pressure waves as a referenc e method and alternatively calibrated distension waves and internally calib rated applanation tonometer readings as test methods. Results In study 1, pulse pressure from internally calibrated tonometer rea dings was 10.2 +/- 14.3 mmHg lower and pulse pressure from alternatively ca librated pressure waves was 1.8 +/- 5.2 mmHg higher than invasive pulse pre ssure. Pulse pressure from calibrated distension waves was 3.4 +/- 6.9 mmHg lower than pulse pressure from alternatively calibrated pressure waves. Ac cording to British Hypertension Society criteria, pulse pressure from the i nternally calibrated tonometer achieved grade D and pulse pressure from alt ernatively calibrated pressure waves achieved grade A. Pulse pressure from calibrated distension waves achieved grade B when alternatively calibrated pressure waves were used as a reference method. Conclusions Pulse pressure obtained from alternatively calibrated tonometer -derived pressure waves and echo-tracking-derived distension waves demonstr ates good accuracy. Accuracy of pulse pressure from internally calibrated a pplanation tonometer readings at the carotid artery is poor.