Abstract 265: Validation of a novel Brachial Pulse Wave Analysis-Based Method for Estimating Central Blood Pressure among Japanese Cardiovascular Patients
Background: Hypertension is a significant predictive factor for future cardiovascular(CV) events. Historically its assessment has been made at the brachial arm, and this method is still cardinal for hypertension treatment.
Blood pressure measured at the root of the aorta, named ‘central’ blood pressure (cBP), shows actual load on the heart and proximal large arteries. It has been recognized as more accurate predictor for CV events than ‘brachial’ one. Despite this, invasive maneuvers on cBP measurement have long limited its widespread clinical use.
Recently several non-invasive methods were developed for cBP measurement. ARC Solver algorithm, which calculates cBP from brachial BP using novel pulse wave analysis-based method, enabled us to assess ambulatory cBP values. Though it was already validated among western countries, its accuracy nor optimal conditions still remains unknown among us Japanese.
Object: To validate ARC Solver algorithm-based cBP measurement among Japanese CV patients.
Method: For 89 patients who underwent elective coronary angiography in our hospital, we simultaneously measured invasive cBP (cBPinv) and calculated cBP with ARC Solver algorithm (cBPcalc) . We used systolic and diastolic BP (Calc1) or mean and diastolic BP(Calc2) for calibration. Then we evaluated the error and correlation of the data with Bland-Altman analysis and Pearson correlation analysis, respectively. After excluding the perturbing factors such as arrhythmia and valvular heart disease, we performed the same analyses.
Results: cBPinv and cBPcalc showed good linear correlation (Cal1: r=0.72, p<0.01, Cal2: r=0.748, p<0.01), whereas error between them showed marked difference (Cal1: 17.7±16.3mmHg, Cal2: -7.5mmHg±18.1mmHg).
After excluding perturbing factors, the difference even enlarged (Cal1: 19.9±17.0mmHg, Cal2: -3.9±15.5mmHg), although linear correlation was each improved (Cal1: r=0.76, p<0.05, Cal2: r=0.84, p<0.01). Gender difference influenced the error.
Conclusions: Mode of calibration significantly influences the calculated cBP with ARC Solver algorithm among Japanese patients with CV diseases. Consideration for the perturbing clinical factors and gender difference are also essential for its proper clinical application.
Author Disclosures: T. Shoji: None. S. Okada: None. A. Nakagomi: None. Y. Kobayashi: None.
- © 2014 by American Heart Association, Inc.