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The influence of SBP amplification on the accuracy of form-factor-derived mean arterial pressure

Schultz, MG ORCID: 0000-0003-3458-1811, Picone, DS ORCID: 0000-0002-4760-1634, Armstrong, MK ORCID: 0000-0002-3948-2452, Black, JA, Dwyer, N ORCID: 0000-0002-1583-8290, Roberts-Thomson, P, Sturgess, D and Sharman, JE ORCID: 0000-0003-2792-0811 2020 , 'The influence of SBP amplification on the accuracy of form-factor-derived mean arterial pressure' , Journal of Hypertension, vol. 38, no. 6 , pp. 1033-1039 , doi: 10.1097/HJH.0000000000002385.

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Abstract

Objectives: Accurate assessment of mean arterial pressure (MAP) is crucial in research and clinical settings. Measurement of MAP requires not only pressure waveform integration but can also be estimated via form-factor equations incorporating peripheral SBP. SBP may increase variably from central-to-peripheral arteries (SBP amplification), and could influence accuracy of form-factor-derived MAP, which we aimed to determine. Methods: One hundred and eighty-eight patients (69% men, age 60 ± 10 years) undergoing coronary angiography had intra-arterial pressure measured in the ascending aorta, brachial and radial arteries. Reference MAP was measured by waveform integration, and form-factor-derived MAP using 33 and 40% form-factors. Results: Reference MAP decreased from the aorta to the brachial (-0.7 ± 4.2 mmHg) and radial artery (-1.7 ± 4.8 mmHg), whereas form-factor-derived MAP increased (33% form-factor 1.1 ± 4.2 and 1.7 ± 4.7 mmHg; 40% form-factor 0.9 ± 4.8 and 1.4 ± 5.4 mmHg, respectively). Form-factor-derived MAP was significantly different to reference aortic MAP (33% form-factor -2.5 ± 4.6 and -1.6 ± 5.8, P P req) to generate MAP equivalent to reference aortic MAP (FFreq range 20-57% brachial; 17-74% radial). Aortic-to-brachial SBP amplification was strongly related to brachial FFreq (r = -0.695, P P = 0.89) but overestimated reference aortic MAP with low aortic-to-brachial SBP amplification (+5.8 ± 4.6 mmHg, P Conclusion: Due to variable SBP amplification, estimating MAP via form-factors produces nonphysiological inaccurate values. These findings have important implications for accurate assessment of MAP in research and clinical settings.

Item Type: Article
Authors/Creators:Schultz, MG and Picone, DS and Armstrong, MK and Black, JA and Dwyer, N and Roberts-Thomson, P and Sturgess, D and Sharman, JE
Keywords: amplification, artery, blood pressure, haemodynamic monitoring, homeostasis
Journal or Publication Title: Journal of Hypertension
Publisher: Lippincott Williams & Wilkins
ISSN: 0263-6352
DOI / ID Number: 10.1097/HJH.0000000000002385
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Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.

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