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Scolletta S, Herpain A, Romano SM, Taccone FS, Donadello K, Lubicz B, Franchi F, Kaefer KM, Polati E, Vincent JL, De Backer D. Estimation of central arterial pressure from the radial artery in patients undergoing invasive neuroradiological procedures. BMC Anesthesiol 2019; 19:173. [PMID: 31484508 PMCID: PMC6727486 DOI: 10.1186/s12871-019-0844-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2019] [Accepted: 08/26/2019] [Indexed: 01/29/2023] Open
Abstract
Backgrounds Central arterial pressure can be derived from analysis of the peripheral artery waveform. The aim of this study was to compare central arterial pressures measured from an intra-aortic catheter with peripheral radial arterial pressures and with central arterial pressures estimated from the peripheral pressure wave using a pressure recording analytical method (PRAM). Methods We studied 21 patients undergoing digital subtraction cerebral angiography under local or general anesthesia and equipped with a radial arterial catheter. A second catheter was placed in the ascending aorta for central pressure wave acquisition. Central (AO) and peripheral (RA) arterial waveforms were recorded simultaneously by PRAM for 90–180 s. During an off-line analysis, AO pressures were reconstructed (AOrec) from the RA trace using a mathematical model obtained by multi-linear regression analysis. The AOrec values obtained by PRAM were compared with the true central pressure value obtained from the catheter placed in the ascending aorta. Results Systolic, diastolic and mean pressures ranged from 79 to 180 mmHg, 47 to 102 mmHg, and 58 to 128 mmHg, respectively, for AO, and 83 to 174 mmHg, 47 to 107 mmHg, and 60 to 129 mmHg, respectively, for RA. The correlation coefficients between AO and RA were 0.86 (p < 0.01), 0.83 (p < 0.01) and 0.86 (p < 0.01) for systolic, diastolic and mean pressures, respectively, and the mean differences − 0.3 mmHg, 2.4 mmHg and 1.5 mmHg. The correlation coefficients between AO and AOrec were 0.92 (p < 0.001), 0.87 (p < 0.001) and 0.92 (p < 0.001), for systolic, diastolic and mean pressures, respectively, and the mean differences 0.01 mmHg, 1.8 mmHg and 1.2 mmHg. Conclusions PRAM can provide reliable estimates of central arterial pressure. Electronic supplementary material The online version of this article (10.1186/s12871-019-0844-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Sabino Scolletta
- Department of Intensive Care, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium. .,Department of Medicine, Surgery and Neurosciences, Anesthesia and Intensive Care Unit, University Hospital of Siena, Siena, Italy.
| | - Antoine Herpain
- Department of Intensive Care, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - Salvatore Mario Romano
- Department of Heart and Vessels, University of Florence, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Fabio Silvio Taccone
- Department of Intensive Care, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - Katia Donadello
- Department of Intensive Care, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium.,Anesthesia and Intensive Care B, Department of Surgery, Dentistry, Paediatrics and Gynaecology, University of Verona, AOUI, University Hospital Integrated Trust of Verona, Verona, Italy
| | - Boris Lubicz
- Department of Interventional Neuroradiology, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - Federico Franchi
- Department of Medicine, Surgery and Neurosciences, Anesthesia and Intensive Care Unit, University Hospital of Siena, Siena, Italy
| | - Keitiane Michele Kaefer
- Department of Intensive Care, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - Enrico Polati
- Anesthesia and Intensive Care B, Department of Surgery, Dentistry, Paediatrics and Gynaecology, University of Verona, AOUI, University Hospital Integrated Trust of Verona, Verona, Italy
| | - Jean-Louis Vincent
- Department of Intensive Care, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - Daniel De Backer
- Department of Intensive Care, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium.,Department of Intensive Care, CHIREC Hospitals, Université Libre de Bruxelles, Brussels, Belgium
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Sharma RK, Verma M, Tiwari RM, Joshi A, Trivedi CA, Chodankar DR. Prevalence and real-world assessment of central aortic blood pressure in adult patients with essential hypertension uncontrolled on single anti-hypertensive agents. Indian Heart J 2018; 70 Suppl 3:S213-S220. [PMID: 30595261 PMCID: PMC6310176 DOI: 10.1016/j.ihj.2018.11.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 10/29/2018] [Accepted: 11/19/2018] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE To assess the prevalence of high central aortic pressure (CAP) in Indian patients with uncontrolled essential hypertension while on anti-hypertensive monotherapy. Also, to determine correlation between brachial blood pressure (BBP) and CAP, and ascertain if it is impacted by anti-hypertensive drug class and patients' age. METHODS In this real-world, observational, prospective study, patients (30-70 years) with uncontrolled BBP (systolic BP [SBP] ≥140 mmHg or diastolic BP [DBP] ≥90 mmHg) were enrolled. Treatment was adjusted at Visit 1 (baseline), based on BBP and at treating physicians' discretion. Primary endpoint was proportion of patients with uncontrolled central aortic SBP (>125 mmHg) at baseline. Secondary endpoints were comparison of BBP and CAP across drugs classes and age groups at baseline and Visit 2 (End-of-study, ∼8 weeks post-baseline), and proportion of patients with uncontrolled central SBP at end-of-study. RESULTS Of 2030 patients screened, 1949 patients reported at baseline and 1740 patients completed end-of-study visit. Central SBP was >125 mmHg for 84.3% patients at baseline, and 48% patients at end-of-study. Interestingly, at end-of-study, 6.6% patients still had uncontrolled brachial SBP and controlled central SBP, while 13.6% patients had uncontrolled central SBP and controlled brachial SBP. At both visits, brachial SBP and central SBP showed positive correlation across most drug classes and age groups. At baseline, ACE inhibitors showed better efficacy than other drug classes. At end-of-study, BP control was better with fixed-dose combinations, though free-drug combinations were more frequently prescribed. CONCLUSION Measurement of CAP along with BBP can be vital in management of hypertension. CTRI REGISTRATION NUMBER CTRI/2015/10/006302.
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Affiliation(s)
- Ranjan Kumar Sharma
- Department of Cardiology, Nil Ratan Sircar Medical College and Hospital, 138, Acharya Jagadish Chandra Bose Road, Kolkata, West Bengal 700014, India.
| | - Manish Verma
- Sanofi House, No 117-B, L & T Business Park, Saki Vihar Road, Powai, Mumbai, Maharashtra 400072, India
| | - Ravi M Tiwari
- Sanofi House, No 117-B, L & T Business Park, Saki Vihar Road, Powai, Mumbai, Maharashtra 400072, India
| | - Abhay Joshi
- Sanofi House, No 117-B, L & T Business Park, Saki Vihar Road, Powai, Mumbai, Maharashtra 400072, India
| | - Chirag A Trivedi
- Sanofi House, No 117-B, L & T Business Park, Saki Vihar Road, Powai, Mumbai, Maharashtra 400072, India
| | - Deepa R Chodankar
- Sanofi House, No 117-B, L & T Business Park, Saki Vihar Road, Powai, Mumbai, Maharashtra 400072, India
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