Estimation of Pulse Transit Time as a Function of Blood Pressure Using a Nonlinear Arterial Tube-Load Model.
Estimation of Pulse Transit Time as a Function of Blood Pressure Using a Nonlinear Arterial Tube-Load Model.
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DOI：
10.1109/tbme.2016.2612639
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发表时间：
2017-07
期刊：
影响因子：
--
通讯作者：
Mukkamala R
中科院分区：
文献类型：
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作者：
Gao M;Cheng HM;Sung SH;Chen CH;Olivier NB;Mukkamala R
脉冲传递时间（PTT）随着整个心脏周期的血压（BP）而变化，然而，由于波反射，通常仅从近端和远端BP波形估计舒张期血压水平的PTT值。目的是建立一种技术，以估计多个PTT值在不同的血压水平在心脏周期。开发了一种从近端和远端BP波形中估计PTT作为BP的函数（以指示每个BP水平的PTT值）的技术。首先，根据考虑bp依赖性动脉顺应性和波反射的非线性动脉管载荷模型的参数，定义了从一种波形到另一种波形的数学变换。然后，通过基于模型的变换对波形进行最优拟合来估计参数。最后，通过参数确定PTT作为BP的函数。该技术在动物和患者中以几种方式进行评估，包括其估计的PTT-BP功能作为校准PTT到BP的受试者特定曲线的能力。在平均血压变化较大的血液动力学干预期间，该技术在基线期间得出的校准曲线的平均血压偏差和精度误差分别为5.1±0.9和6.6±1.0 mmHg。这项新技术可能首次允许从近端和远端波形估计整个心脏周期的PTT值。意义：该技术可用于改善动脉僵硬监测，实现无袖带血压监测。
pulse transit time (PTT) varies with blood pressure (BP) throughout the cardiac cycle, yet, because of wave reflection, only one PTT value at the diastolic BP level is conventionally estimated from proximal and distal BP waveforms. The objective was to establish a technique to estimate multiple PTT values at different BP levels in the cardiac cycle. a technique was developed for estimating PTT as a function of BP (to indicate the PTT value for every BP level) from proximal and distal BP waveforms. First, a mathematical transformation from one waveform to the other is defined in terms of the parameters of a nonlinear arterial tube-load model accounting for BP-dependent arterial compliance and wave reflection. Then, the parameters are estimated by optimally fitting the waveforms to each other via the model-based transformation. Finally, PTT as a function of BP is specified by the parameters. The technique was assessed in animals and patients in several ways including the ability of its estimated PTT-BP function to serve as a subject-specific curve for calibrating PTT to BP. the calibration curve derived by the technique during a baseline period yielded bias and precision errors in mean BP of 5.1 ± 0.9 and 6.6 ± 1.0 mmHg, respectively, during hemodynamic interventions that varied mean BP widely. the new technique may permit, for the first time, estimation of PTT values throughout the cardiac cycle from proximal and distal waveforms. Significance: the technique could potentially be applied to improve arterial stiffness monitoring and help realize cuff-less BP monitoring.