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Updated: May 19, 2026
Measuring the Carotid to Femoral Pulse Wave Velocity (Cf-PWV) to Evaluate Arterial Stiffness
Published on: May 3, 2018
Measurement of central aortic pulse pressure: noninvasive brachial cuff-based estimation by a transfer function vs. a
Hao-Min Cheng1, Shih-Hsien Sung, Yuan-Ta Shih
1The Joanna Briggs Institute, The University of Adelaide, Adelaide, Australia.
Background:
The prognostic value of central aortic pulse pressure (PP-C) may have been underestimated due to its measurement inaccuracy. We aimed to investigate the accuracy of noninvasive brachial cuff-based estimation of PP-C by a generalized transfer function (GTF) or a novel pulse wave analysis (PWA) approach to directly estimate PP-C.
Methods:
Invasive high-fidelity right brachial and central aortic pressure tracings, and left brachial pulse volume plethysmography (PVP) waveforms from an oscillometric blood pressure (BP) monitor were all digitized simultaneously in 40 patients during cardiac catheterization. An aortic-to-brachial GTF and a PWA multivariate prediction model using the PVP waveforms calibrated to brachial cuff systolic BP (SBP) and diastolic BP(DBP) were constructed. Accuracy of the two methods was examined in another 100 patients against invasively measured PP-C.
Results:
The error of cuff PP in estimating PP-C was 1.8 ± 12.4 mm Hg. Application of the GTF on noninvasively calibrated PVP waveforms produced reconstructed aortic pressure waves and PP-C estimates with errors of -3.4 ± 11.6 mm Hg (PP-C = reconstructed aortic SBP - aortic DBP) and -2.3 ± 11.4 mm Hg (PP-C = reconstructed aortic SBP - cuff DBP), respectively. The observed systematic errors were proportional to the magnitudes of PP-C. In contrast, the error of the PWA prediction model was 3.0 ± 7.1 mm Hg without obvious proportional systematic error.
Conclusions:
Large random and systematic errors are introduced into the PP-C estimates when PP-C is calculated as the difference between the estimated central SBP and central or cuff DBP. The accuracy can be improved substantially with the novel PWA approach.
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The Brachial Artery: Primary Site for Blood Pressure Measurement
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Prepare for the Procedure:
01:30Equipments Used To Measure Blood Pressure
This invasive approach involves cannulating a peripheral artery. During each cardiac contraction, pressure generates mechanical motion within the catheter, transmitted through rigid, fluid-filled tubing to a transducer. This transducer converts mechanical motion into electrical signals displayed as waveforms on a monitor. An automatic flushing system prevents blood backflow. Due to the potential risk of unexpected arterial blood loss, this method is primarily used in intensive...
01:17Measurement of Blood Pressure
01:28Special considerations while measuring blood pressure
Monitoring Both Arms:
Monitoring BP in both arms during the initial assessment is advisable, as the systolic value may differ by five to ten mm Hg between arms. For subsequent BP assessments, use the arm with the higher reading.