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Non-invasive estimation of aortic blood pressures: a close look at current devices and methods
Sandrine Millasseau, Davide Agnoletti1
1Pulse Wave Consulting, 72 bis rue de Montlignon, 95320 Saint Leu la Foret, France. sandrine_millasseau@yahoo.fr.
Insights
Aortic pressure measurements, particularly systolic and pulse pressures, offer superior cardiovascular risk prediction compared to traditional cuff pressure. This review evaluates non-invasive methods for assessing aortic pressure, highlighting their strengths and limitations.
Area of Science:
- Cardiology
- Biomedical Engineering
- Medical Devices
Background:
- Clinician use of brachial cuff pressure for cardiovascular risk assessment is longstanding.
- Emerging evidence indicates aortic systolic and pulse pressures possess greater prognostic value for cardiovascular events and mortality.
Purpose of the Study:
- To review and compare various non-invasive techniques and devices for estimating aortic systolic pressure.
- To present the strengths and weaknesses of different methods for assessing central aortic pressure.
Main Methods:
- Review of non-invasive techniques including tonometry, ultrasound, transfer function, and mathematical modeling.
- Analysis of methods utilizing carotid, radial, or brachial waveforms.
- Evaluation of devices that may use brachial cuff pressure for scaling.
Main Results:
- Multiple non-invasive methods exist to estimate aortic pressure.
- Techniques vary in accuracy and reliability.
- A significant limitation is the reliance of some methods on brachial cuff pressure for calibration.
Conclusions:
- Aortic pressure estimation offers improved cardiovascular risk prediction.
- Understanding the limitations of different non-invasive techniques is crucial for accurate assessment.
- Further research is needed to refine and validate devices for reliable aortic pressure measurement.
Abstract:
While for years clinicians have used cuff pressure to assess patients' cardiovascular risk, recent evidences has shown that aortic pressure, or more specifically aortic systolic and aortic pulse pressures, have a better prognostic value to predict cardiovascular events and mortality. This led to the emergence of multiple methods and devices to assess aortic pressure non-invasively. Some use scaled waveforms measured at the carotid level with tonometry, or ultrasounds. Others use transfer function or mathematical modelling from radial or brachial traces acquired from volume plethsymography or applanation tonometry. Not all these techniques are equivalent and most of them have the major flaw of using brachial cuff pressure to scale their results. The purpose of this review is to present the strengths and weaknesses of techniques and various commercial devices to estimate aortic systolic pressure.
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