Comparison of noninvasive pulse transit time estimates as markers of blood pressure using invasive pulse transit time measurements as a reference.
Comparison of noninvasive pulse transit time estimates as markers of blood pressure using invasive pulse transit time measurements as a reference.
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DOI：
10.14814/phy2.12768
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发表时间：
2016-05
影响因子：
2.5
通讯作者：
Mukkamala R
中科院分区：
文献类型：
--
作者：
Gao M;Olivier NB;Mukkamala R
脉搏传递时间（PTT）是指有创近端和远端血压（BP）或血流波形之间的时间延迟（有创PTT [I‐PTT]）与BP密切相关。PTT估计为无创近端和远端动脉波形之间的时间延迟，因此可以进行无袖带血压监测。对于这种应用，一种流行的无创PTT估计是ECG和光电体积脉搏波（PPG）波形之间的时间延迟（脉冲到达时间[PAT]）。另一个估计是近端和远端PPG波形之间的时间延迟（PPG - PTT）。以I - PTT作为参考，评估PAT和PPG - PTT作为广泛生理范围内的BP标志物。在基线条件下和注射各种血液动力学药物时，测量猪中央动脉I - PTT、PAT和PPG - PTT的波形。每位受试者的舒张、平均和收缩压差异很大（组平均（mean±SE）标准差在25±2和36±2 mmHg之间）。I - PTT与所有血压水平相关良好（组平均r2值在0.86±0.03和0.91±0.03之间）。PPG‐PTT与所有血压水平均有良好的相关性（组平均r2值在0.81±0.03 ~ 0.85±0.02之间），其r2值与I‐PTT无显著差异。PAT与收缩压相关性最好（组平均r2值为0.70±0.04），但其所有血压水平的r2值均显著低于I - PTT （P < 0.005）和PPG - PTT （P < 0.02）。PAT的射前期成分与BP的相关性较低。综上所述，PPG - PTT与I - PTT没有区别，并且优于常用的PAT作为BP的标记物。
Pulse transit time (PTT) measured as the time delay between invasive proximal and distal blood pressure (BP) or flow waveforms (invasive PTT [I‐PTT]) tightly correlates with BP. PTT estimated as the time delay between noninvasive proximal and distal arterial waveforms could therefore permit cuff‐less BP monitoring. A popular noninvasive PTT estimate for this application is the time delay between ECG and photoplethysmography (PPG) waveforms (pulse arrival time [PAT]). Another estimate is the time delay between proximal and distal PPG waveforms (PPG‐PTT). PAT and PPG‐PTT were assessed as markers of BP over a wide physiologic range using I‐PTT as a reference. Waveforms for determining I‐PTT, PAT, and PPG‐PTT through central arteries were measured from swine during baseline conditions and infusions of various hemodynamic drugs. Diastolic, mean, and systolic BP varied widely in each subject (group average (mean ± SE) standard deviation between 25 ± 2 and 36 ± 2 mmHg). I‐PTT correlated well with all BP levels (group average R 2 values between 0.86 ± 0.03 and 0.91 ± 0.03). PPG‐PTT also correlated well with all BP levels (group average R 2 values between 0.81 ± 0.03 and 0.85 ± 0.02), and its R 2 values were not significantly different from those of I‐PTT. PAT correlated best with systolic BP (group average R 2 value of 0.70 ± 0.04), but its R 2 values for all BP levels were significantly lower than those of I‐PTT (P < 0.005) and PPG‐PTT (P < 0.02). The pre‐ejection period component of PAT was responsible for its inferior correlation with BP. In sum, PPG‐PTT was not different from I‐PTT and superior to the popular PAT as a marker of BP.