Pulse arrival time is not an adequate surrogate for pulse transit time as a marker of blood pressure
Pulse arrival time is not an adequate surrogate for pulse transit time as a marker of blood pressure
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DOI：
10.1152/japplphysiol.00980.2011
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发表时间：
2011-12-01
影响因子：
3.3
通讯作者：
Mukkamala, Ramakrishna
中科院分区：
文献类型：
--
作者：
Zhang, Guanqun;Gao, Mingwu;Mukkamala, Ramakrishna
张刚，高明，徐东，奥利维耶NB，穆卡马拉R.脉搏到达时间不能作为脉搏传导时间的适当替代物作为血压的标志。J Appl Physiol 111：1681-1686，2011.首次发表于2011年9月29日; doi：10.1152/japplphysiol.00980.2011。脉搏传导时间（PTT）是一种经过验证的、易于测量的血压（BP）标志物，可能允许连续、无创和无袖带BP监测（初始校准后）。然而，等于PTT和射血前期之和的脉搏到达时间（PAT）在BP跟踪中越来越受欢迎，因为它更容易测量。本研究的目的是评估PAT是PTT作为BP标志物的适当替代物的假设。PAT和PTT估计通过主动脉使用高保真侵入性动脉波形从六只狗在广泛的BP变化引起的多次干预。根据预测每只动物舒张压、平均血压和收缩压（DBP、MBP和SBP）的能力，评价这些时间延迟及其倒数。通过时间延迟预测的BP参数和测量的BP参数之间的均方根误差（RMSE）被专门用作评估指标。取时间延迟的倒数往往会降低RMSE值。1/PAT的DBP、MBP和SBP RMSE值分别为9.8 ± 5.2、10.4 ± 5.6和11.9 ± 6.1 mmHg，而1/PTT的相应值分别为5.3 ± 1.2、4.8 ± 1.0和7.5 ± 2.2 mmHg（P < 0.05）。因此，通过PAT跟踪BP不仅明显比通过PTT差，而且也无法满足FDA BP误差限值。与以前的研究相比，我们的结果定量地表明，在检测具有挑战性的BP变化方面，PAT不是PTT的适当替代品。
Zhang G, Gao M, Xu D, Olivier NB, Mukkamala R. Pulse arrival time is not an adequate surrogate for pulse transit time as a marker of blood pressure. J Appl Physiol 111: 1681-1686, 2011. First published September 29, 2011; doi:10.1152/japplphysiol.00980.2011.-Pulse transit time (PTT) is a proven, simple to measure, marker of blood pressure (BP) that could potentially permit continuous, noninvasive, and cuff-less BP monitoring (after an initial calibration). However, pulse arrival time (PAT), which is equal to the sum of PTT and the pre-ejection period, is gaining popularity for BP tracking, because it is even simpler to measure. The aim of this study was to evaluate the hypothesis that PAT is an adequate surrogate for PTT as a marker of BP. PAT and PTT were estimated through the aorta using high-fidelity invasive arterial waveforms obtained from six dogs during wide BP changes induced by multiple interventions. These time delays and their reciprocals were evaluated in terms of their ability to predict diastolic, mean, and systolic BP (DBP, MBP, and SBP) per animal. The root mean squared error (RMSE) between the BP parameter predicted via the time delay and the measured BP parameter was specifically used as the evaluation metric. Taking the reciprocals of the time delays tended to reduce the RMSE values. The DBP, MBP, and SBP RMSE values for 1/PAT were 9.8 +/- 5.2, 10.4 +/- 5.6, and 11.9 +/- 6.1 mmHg, whereas the corresponding values for 1/PTT were 5.3 +/- 1.2, 4.8 +/- 1.0, and 7.5 +/- 2.2 mmHg (P < 0.05). Thus tracking BP via PAT was not only markedly worse than via PTT but also unable to meet the FDA BP error limits. In contrast to previous studies, our results quantitatively indicate that PAT is not an adequate surrogate for PTT in terms of detecting challenging BP changes.