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
Categorie Soggetti
Cardiovascular & Respiratory Systems","Cardiovascular & Hematology Research
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.