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Aortic pressure wave reconstruction during exercise is improved by adaptive filtering: a pilot study.
Wim J Stok1, Berend E Westerhof, Ilja Guelen
1Heart Failure Research Centre, Academic Medical Center, University of Amsterdam, Room M01-215, Meibergdreef 9, NL-1105 AZ, Amsterdam, The Netherlands. w.stok@amc.uva.nl
Medical & Biological Engineering & Computing
|July 2, 2011
Summary
Individualizing the transfer function (indTF) significantly improves central aortic pressure estimation during exercise. This method enhances accuracy for systolic and pulse pressure compared to the generalized transfer function (genTF).
Area of Science:
- Cardiovascular Physiology
- Biomedical Engineering
- Hemodynamics
Background:
- Accurate central aortic pressure measurement is crucial for cardiovascular assessment.
- Generalized transfer functions (genTF) for reconstructing central pressure from peripheral measurements show reduced accuracy during heavy exercise.
- Systolic and pulse pressure estimations deteriorate with genTF, leading to underestimation of central pressure.
Purpose of the Study:
- To investigate the efficacy of individualizing the peripheral to aortic pressure transfer function (indTF) during exercise.
- To improve the accuracy of central blood pressure assessment, particularly systolic and pulse pressure, during varying exercise intensities.
- To evaluate the impact of adapting the transfer function's resonance frequency and calibration on pressure reconstruction accuracy.
Main Methods:
- Simultaneous measurement of central and peripheral pressures in seven males (age 44-57) with coronary artery disease during exercise.
- Individualization of the transfer function (indTF) by adapting resonance frequency using regression formulas based on peripheral pressure pulse variables, including pulse contour cardiac output (pcCO).
- Calibration of reconstructed pressures to central mean and diastolic pressure at each exercise level.
Main Results:
- The error in estimated aortic pulse pressure using genTF without calibration was -7.5 ± 6.4 mmHg.
- Individualized transfer functions (indTFs) using pcCO reduced the error to 0.2 ± 5.7 mmHg.
- Calibration further reduced scatter but introduced a small bias (2.7 mmHg); indTFs demonstrated superior prediction of systolic and pulse pressure during exercise compared to genTF.
Conclusions:
- Individualizing the peripheral to aortic pressure transfer function is feasible and enhances the accuracy of central blood pressure assessment during exercise.
- Adapted resonance frequency and calibration methods contribute to improved hemodynamic monitoring in patients with cardiovascular disease.
- This pilot study highlights the potential of indTF for more reliable non-invasive central pressure monitoring during physical exertion.
