Measurement accuracy of non-invasively obtained central blood pressure by applanation tonometry: A systematic review and meta-analysis
Non-invasive methods based on applanation tonometry have been proposed to estimate central blood pressure. However, the accuracy of these methods hasn't been systematically examined. We performed a systematic review and meta-analysis of studies comparing estimated and invasively measured centra...
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Published in | International journal of cardiology Vol. 167; no. 5; pp. 1867 - 1876 |
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Main Authors | , , , |
Format | Journal Article |
Language | English |
Published |
Shannon
Elsevier Ireland Ltd
01.09.2013
Elsevier |
Subjects | |
Online Access | Get full text |
ISSN | 0167-5273 1874-1754 1874-1754 |
DOI | 10.1016/j.ijcard.2012.04.155 |
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Abstract | Non-invasive methods based on applanation tonometry have been proposed to estimate central blood pressure. However, the accuracy of these methods hasn't been systematically examined.
We performed a systematic review and meta-analysis of studies comparing estimated and invasively measured central BP.
Sufficient data were available in 22 studies for meta-analysis (857 subjects and 1167 measurements). Acquired arterial pressure waveforms in these studies were directly measured, calibrated to match invasive aortic mean BP and diastolic BP or calibrated to match brachial BP measured with a sphygmomanometer, cuff BP. Of the former 2 conditions, the errors of estimated central BP were small with a mean and standard deviation of difference −1.1±4.1mm Hg (95% limits of agreement −9.1–6.9mm Hg) for central systolic BP; −0.5±2.1mm Hg (−4.6–3.6mm Hg) for central diastolic BP; and −0.8±5.1mm Hg (−10.8–9.2mm Hg) for central pulse pressure. However, the errors inflated to −8.2±10.3mm Hg (−28.4–12.0mm Hg) for central systolic BP, 7.6±8.7mm Hg (−9.5–24.6mm Hg) for central diastolic BP, and −12.2±10.4mm Hg (−32.5–8.1mm Hg) for central pulse pressure, when calibrated to cuff BP. The findings were still evident in subgroup analysis conducted with different central BP estimating methods and validated cuff BP monitors.
Present tonometry-based central BP estimating methods are acceptable in theory, with small errors. However, based on current available evidence, there is substantial room for improvement in measurement accuracy of central BP when cuff BP is used to calibrate the peripheral waveforms. |
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AbstractList | Abstract Background and objectives Non-invasive methods based on applanation tonometry have been proposed to estimate central blood pressure. However, the accuracy of these methods hasn't been systematically examined. Methods We performed a systematic review and meta-analysis of studies comparing estimated and invasively measured central BP. Results Sufficient data were available in 22 studies for meta-analysis (857 subjects and 1167 measurements). Acquired arterial pressure waveforms in these studies were directly measured, calibrated to match invasive aortic mean BP and diastolic BP or calibrated to match brachial BP measured with a sphygmomanometer, cuff BP. Of the former 2 conditions, the errors of estimated central BP were small with a mean and standard deviation of difference − 1.1 ± 4.1 mm Hg (95% limits of agreement − 9.1–6.9 mm Hg) for central systolic BP; − 0.5 ± 2.1 mm Hg (− 4.6–3.6 mm Hg) for central diastolic BP; and − 0.8 ± 5.1 mm Hg (− 10.8–9.2 mm Hg) for central pulse pressure. However, the errors inflated to − 8.2 ± 10.3 mm Hg (− 28.4–12.0 mm Hg) for central systolic BP, 7.6 ± 8.7 mm Hg (− 9.5–24.6 mm Hg) for central diastolic BP, and − 12.2 ± 10.4 mm Hg (− 32.5–8.1 mm Hg) for central pulse pressure, when calibrated to cuff BP. The findings were still evident in subgroup analysis conducted with different central BP estimating methods and validated cuff BP monitors. Conclusion Present tonometry-based central BP estimating methods are acceptable in theory, with small errors. However, based on current available evidence, there is substantial room for improvement in measurement accuracy of central BP when cuff BP is used to calibrate the peripheral waveforms. Non-invasive methods based on applanation tonometry have been proposed to estimate central blood pressure. However, the accuracy of these methods hasn't been systematically examined. We performed a systematic review and meta-analysis of studies comparing estimated and invasively measured central BP. Sufficient data were available in 22 studies for meta-analysis (857 subjects and 1167 measurements). Acquired arterial pressure waveforms in these studies were directly measured, calibrated to match invasive aortic mean BP and diastolic BP or calibrated to match brachial BP measured with a sphygmomanometer, cuff BP. Of the former 2 conditions, the errors of estimated central BP were small with a mean and standard deviation of difference −1.1±4.1mm Hg (95% limits of agreement −9.1–6.9mm Hg) for central systolic BP; −0.5±2.1mm Hg (−4.6–3.6mm Hg) for central diastolic BP; and −0.8±5.1mm Hg (−10.8–9.2mm Hg) for central pulse pressure. However, the errors inflated to −8.2±10.3mm Hg (−28.4–12.0mm Hg) for central systolic BP, 7.6±8.7mm Hg (−9.5–24.6mm Hg) for central diastolic BP, and −12.2±10.4mm Hg (−32.5–8.1mm Hg) for central pulse pressure, when calibrated to cuff BP. The findings were still evident in subgroup analysis conducted with different central BP estimating methods and validated cuff BP monitors. Present tonometry-based central BP estimating methods are acceptable in theory, with small errors. However, based on current available evidence, there is substantial room for improvement in measurement accuracy of central BP when cuff BP is used to calibrate the peripheral waveforms. Non-invasive methods based on applanation tonometry have been proposed to estimate central blood pressure. However, the accuracy of these methods hasn't been systematically examined. We performed a systematic review and meta-analysis of studies comparing estimated and invasively measured central BP. Sufficient data were available in 22 studies for meta-analysis (857 subjects and 1167 measurements). Acquired arterial pressure waveforms in these studies were directly measured, calibrated to match invasive aortic mean BP and diastolic BP or calibrated to match brachial BP measured with a sphygmomanometer, cuff BP. Of the former 2 conditions, the errors of estimated central BP were small with a mean and standard deviation of difference -1.1 ± 4.1mm Hg (95% limits of agreement -9.1-6.9 mm Hg) for central systolic BP; -0.5 ± 2.1mm Hg (-4.6-3.6mm Hg) for central diastolic BP; and -0.8 ± 5.1mm Hg (-10.8-9.2mm Hg) for central pulse pressure. However, the errors inflated to -8.2 ± 10.3mm Hg (-28.4-12.0mm Hg) for central systolic BP, 7.6 ± 8.7 mm Hg (-9.5-24.6mm Hg) for central diastolic BP, and -12.2 ± 10.4mm Hg (-32.5-8.1mm Hg) for central pulse pressure, when calibrated to cuff BP. The findings were still evident in subgroup analysis conducted with different central BP estimating methods and validated cuff BP monitors. Present tonometry-based central BP estimating methods are acceptable in theory, with small errors. However, based on current available evidence, there is substantial room for improvement in measurement accuracy of central BP when cuff BP is used to calibrate the peripheral waveforms. Non-invasive methods based on applanation tonometry have been proposed to estimate central blood pressure. However, the accuracy of these methods hasn't been systematically examined.BACKGROUND AND OBJECTIVESNon-invasive methods based on applanation tonometry have been proposed to estimate central blood pressure. However, the accuracy of these methods hasn't been systematically examined.We performed a systematic review and meta-analysis of studies comparing estimated and invasively measured central BP.METHODSWe performed a systematic review and meta-analysis of studies comparing estimated and invasively measured central BP.Sufficient data were available in 22 studies for meta-analysis (857 subjects and 1167 measurements). Acquired arterial pressure waveforms in these studies were directly measured, calibrated to match invasive aortic mean BP and diastolic BP or calibrated to match brachial BP measured with a sphygmomanometer, cuff BP. Of the former 2 conditions, the errors of estimated central BP were small with a mean and standard deviation of difference -1.1 ± 4.1mm Hg (95% limits of agreement -9.1-6.9 mm Hg) for central systolic BP; -0.5 ± 2.1mm Hg (-4.6-3.6mm Hg) for central diastolic BP; and -0.8 ± 5.1mm Hg (-10.8-9.2mm Hg) for central pulse pressure. However, the errors inflated to -8.2 ± 10.3mm Hg (-28.4-12.0mm Hg) for central systolic BP, 7.6 ± 8.7 mm Hg (-9.5-24.6mm Hg) for central diastolic BP, and -12.2 ± 10.4mm Hg (-32.5-8.1mm Hg) for central pulse pressure, when calibrated to cuff BP. The findings were still evident in subgroup analysis conducted with different central BP estimating methods and validated cuff BP monitors.RESULTSSufficient data were available in 22 studies for meta-analysis (857 subjects and 1167 measurements). Acquired arterial pressure waveforms in these studies were directly measured, calibrated to match invasive aortic mean BP and diastolic BP or calibrated to match brachial BP measured with a sphygmomanometer, cuff BP. Of the former 2 conditions, the errors of estimated central BP were small with a mean and standard deviation of difference -1.1 ± 4.1mm Hg (95% limits of agreement -9.1-6.9 mm Hg) for central systolic BP; -0.5 ± 2.1mm Hg (-4.6-3.6mm Hg) for central diastolic BP; and -0.8 ± 5.1mm Hg (-10.8-9.2mm Hg) for central pulse pressure. However, the errors inflated to -8.2 ± 10.3mm Hg (-28.4-12.0mm Hg) for central systolic BP, 7.6 ± 8.7 mm Hg (-9.5-24.6mm Hg) for central diastolic BP, and -12.2 ± 10.4mm Hg (-32.5-8.1mm Hg) for central pulse pressure, when calibrated to cuff BP. The findings were still evident in subgroup analysis conducted with different central BP estimating methods and validated cuff BP monitors.Present tonometry-based central BP estimating methods are acceptable in theory, with small errors. However, based on current available evidence, there is substantial room for improvement in measurement accuracy of central BP when cuff BP is used to calibrate the peripheral waveforms.CONCLUSIONPresent tonometry-based central BP estimating methods are acceptable in theory, with small errors. However, based on current available evidence, there is substantial room for improvement in measurement accuracy of central BP when cuff BP is used to calibrate the peripheral waveforms. |
Author | Cheng, Hao-Min Pearson, Alan Tufanaru, Catalin Lang, Dora |
Author_xml | – sequence: 1 givenname: Hao-Min surname: Cheng fullname: Cheng, Hao-Min email: hao-min.cheng@adelaide.edu.au organization: The Joanna Briggs Institute, Faculty of Health Sciences, The University of Adelaide, Adelaide, Australia – sequence: 2 givenname: Dora surname: Lang fullname: Lang, Dora organization: The Joanna Briggs Institute, Faculty of Health Sciences, The University of Adelaide, Adelaide, Australia – sequence: 3 givenname: Catalin surname: Tufanaru fullname: Tufanaru, Catalin organization: The Joanna Briggs Institute, Faculty of Health Sciences, The University of Adelaide, Adelaide, Australia – sequence: 4 givenname: Alan surname: Pearson fullname: Pearson, Alan organization: The Joanna Briggs Institute, Faculty of Health Sciences, The University of Adelaide, Adelaide, Australia |
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Keywords | SphygmoCor Late systolic peak Central blood pressure Transfer function Sphygmomanometer Applanation tonometry Late Cardiovascular disease Systematic review Sphygmomanometry Metaanalysis Arterial pressure Peak Blood pressure Hemodynamics Measurement accuracy Cardiology |
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Snippet | Non-invasive methods based on applanation tonometry have been proposed to estimate central blood pressure. However, the accuracy of these methods hasn't been... Abstract Background and objectives Non-invasive methods based on applanation tonometry have been proposed to estimate central blood pressure. However, the... |
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SubjectTerms | Applanation tonometry Biological and medical sciences Blood Pressure - physiology Blood Pressure Determination - methods Blood Pressure Determination - standards Calibration - standards Cardiology. Vascular system Cardiovascular Central blood pressure Heart Humans Late systolic peak Manometry - methods Manometry - standards Medical sciences SphygmoCor Sphygmomanometer Transfer function |
Title | Measurement accuracy of non-invasively obtained central blood pressure by applanation tonometry: A systematic review and meta-analysis |
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