Central-to-peripheral blood pressure amplification: role of the recording site, technology, analysis approach, and calibration scheme in invasive and non-invasive data agreement
Resumen:
Background: Systolic blood pressure amplification (SBPA) and pulse pressure amplification (PPA) can independently predict cardiovascular damage and mortality. A wide range of methods are used for the non-invasive estimation of SBPA and PPA. The most accurate non-invasive method for obtaining SBPA and/or PPA remains unknown. Aim: This study aims to evaluate the agreement between the SBPA and PPA values that are invasively and non-invasively obtained using different (1) measurement sites (radial, brachial, carotid), (2) measuring techniques (tonometry, oscillometry/plethysmography, ultrasound), (3) pulse waveform analysis approaches, and (4) calibration methods [systo-diastolic vs. approaches using brachial diastolic and mean blood pressure (BP)], with the latter calculated using different equations or measured by oscillometry. Methods: Invasive aortic and brachial pressure (catheterism) and non-invasive aortic and peripheral (brachial, radial) BP were simultaneously obtained from 34 subjects using different methodologies, analysis methods, measuring sites, and calibration methods. SBPA and PPA were quantified. Concordance correlation and the Bland-Altman analysis were performed. Results: (1) In general, SBPA and PPA levels obtained with non-invasive approaches were not associated with those recorded invasively. (2) The different non-invasive approaches led to (extremely) dissimilar results. In general, non-invasive measurements underestimated SBPA and PPA; the higher the invasive SBPA (or PPA), the greater the underestimation. (3) None of the calibration schemes, which considered non-invasive brachial BP to estimate SBPA or PPA, were better than the others. (4) SBPA and PPA levels obtained from radial artery waveform analysis (tonometry) (5) and common carotid artery ultrasound recordings and brachial artery waveform analysis, respectively, minimized the mean errors. Conclusions: Overall, the findings showed that (i) SBPA and PPA indices are not "synonymous" and (ii) non-invasive approaches would fail to accurately determine invasive SBPA or PPA levels, regardless of the recording site, analysis, and calibration methods. Non-invasive measurements generally underestimated SBPA and PPA, and the higher the invasive SBPA or PPA, the higher the underestimation. There was not a calibration scheme better than the others. Consequently, our study emphasizes the strong need to be critical of measurement techniques, to have methodological transparency, and to have expert consensus for non-invasive assessment of SBPA and PPA.
| 2023 | |
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Applanation tonometry Calibration Central-to-peripheral blood pressure amplification Invasive records Non-invasive records Oscillometry Physiology Vascular ultrasound TONOMETRÍA OCULAR CALIBRACIÓN PRESIÓN ARTERIAL OSCILOMETRÍA FISIOLOGÍA ULTRASONOGRAFÍA |
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| Inglés | |
| Universidad de la República | |
| COLIBRI | |
| https://hdl.handle.net/20.500.12008/54324 | |
| Acceso abierto | |
| Licencia Creative Commons Atribución (CC - By 4.0) |
| _version_ | 1875692820732313600 |
|---|---|
| author | Zócalo, Yanina |
| author2 | Bia, Daniel Sánchez, Ramiro Lev, Gustavo Mendiz, Oscar Ramírez, Agustín Cabrera-Fischer, Edmundo I. |
| author2_role | author author author author author author |
| author_facet | Zócalo, Yanina Bia, Daniel Sánchez, Ramiro Lev, Gustavo Mendiz, Oscar Ramírez, Agustín Cabrera-Fischer, Edmundo I. |
| author_role | author |
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| collection | COLIBRI |
| dc.contributor.filiacion.none.fl_str_mv | Zócalo Yanina, Universidad de la República (Uruguay). Facultad de Medicina. Departamento de Fisiología Bia Daniel, Universidad de la República (Uruguay). Facultad de Medicina. Departamento de Fisiología Sánchez Ramiro, Fundación Favaloro (Argentina). Hospital Universitario Lev Gustavo, Fundación Favaloro (Argentina). Hospital Universitario Mendiz Oscar, Fundación Favaloro (Argentina). Hospital Universitario Ramírez Agustín, Consejo Nacional de Investigaciones Científicas y Técnicas (Argentina). Instituto de Medicina Traslacional, Trasplante y Bioingeniería Cabrera-Fischer Edmundo I., Consejo Nacional de Investigaciones Científicas y Técnicas (Argentina). Instituto de Medicina Traslacional, Trasplante y Bioingeniería |
| dc.creator.none.fl_str_mv | Zócalo, Yanina Bia, Daniel Sánchez, Ramiro Lev, Gustavo Mendiz, Oscar Ramírez, Agustín Cabrera-Fischer, Edmundo I. |
| dc.date.accessioned.none.fl_str_mv | 2026-04-13T17:38:33Z |
| dc.date.available.none.fl_str_mv | 2026-04-13T17:38:33Z |
| dc.date.issued.none.fl_str_mv | 2023 |
| dc.description.abstract.none.fl_txt_mv | Background: Systolic blood pressure amplification (SBPA) and pulse pressure amplification (PPA) can independently predict cardiovascular damage and mortality. A wide range of methods are used for the non-invasive estimation of SBPA and PPA. The most accurate non-invasive method for obtaining SBPA and/or PPA remains unknown. Aim: This study aims to evaluate the agreement between the SBPA and PPA values that are invasively and non-invasively obtained using different (1) measurement sites (radial, brachial, carotid), (2) measuring techniques (tonometry, oscillometry/plethysmography, ultrasound), (3) pulse waveform analysis approaches, and (4) calibration methods [systo-diastolic vs. approaches using brachial diastolic and mean blood pressure (BP)], with the latter calculated using different equations or measured by oscillometry. Methods: Invasive aortic and brachial pressure (catheterism) and non-invasive aortic and peripheral (brachial, radial) BP were simultaneously obtained from 34 subjects using different methodologies, analysis methods, measuring sites, and calibration methods. SBPA and PPA were quantified. Concordance correlation and the Bland-Altman analysis were performed. Results: (1) In general, SBPA and PPA levels obtained with non-invasive approaches were not associated with those recorded invasively. (2) The different non-invasive approaches led to (extremely) dissimilar results. In general, non-invasive measurements underestimated SBPA and PPA; the higher the invasive SBPA (or PPA), the greater the underestimation. (3) None of the calibration schemes, which considered non-invasive brachial BP to estimate SBPA or PPA, were better than the others. (4) SBPA and PPA levels obtained from radial artery waveform analysis (tonometry) (5) and common carotid artery ultrasound recordings and brachial artery waveform analysis, respectively, minimized the mean errors. Conclusions: Overall, the findings showed that (i) SBPA and PPA indices are not "synonymous" and (ii) non-invasive approaches would fail to accurately determine invasive SBPA or PPA levels, regardless of the recording site, analysis, and calibration methods. Non-invasive measurements generally underestimated SBPA and PPA, and the higher the invasive SBPA or PPA, the higher the underestimation. There was not a calibration scheme better than the others. Consequently, our study emphasizes the strong need to be critical of measurement techniques, to have methodological transparency, and to have expert consensus for non-invasive assessment of SBPA and PPA. |
| dc.format.extent.es.fl_str_mv | 19 p. |
| dc.format.mimetype.es.fl_str_mv | application/pdf |
| dc.identifier.citation.es.fl_str_mv | Zócalo Y, Bia D, Sánchez R y otros. Central-to-peripheral blood pressure amplification: role of the recording site, technology, analysis approach, and calibration scheme in invasive and non-invasive data agreement. Frontiers in Cardiovascular Medicine [en línea]. 2023;10. 19 p. |
| dc.identifier.doi.none.fl_str_mv | 10.3389/fcvm.2023.1256221 |
| dc.identifier.eissn.none.fl_str_mv | 2297-055X |
| dc.identifier.uri.none.fl_str_mv | https://hdl.handle.net/20.500.12008/54324 |
| dc.language.iso.none.fl_str_mv | en eng |
| dc.publisher.es.fl_str_mv | Frontiers Media |
| dc.relation.none.fl_str_mv | Frontiers in Cardiovascular Medicine. 2023;10 |
| dc.rights.license.none.fl_str_mv | Licencia Creative Commons Atribución (CC - By 4.0) |
| dc.rights.none.fl_str_mv | info:eu-repo/semantics/openAccess |
| dc.source.none.fl_str_mv | reponame:COLIBRI instname:Universidad de la República instacron:Universidad de la República |
| dc.subject.es.fl_str_mv | Applanation tonometry Calibration Central-to-peripheral blood pressure amplification Invasive records Non-invasive records Oscillometry Physiology Vascular ultrasound |
| dc.subject.other.es.fl_str_mv | TONOMETRÍA OCULAR CALIBRACIÓN PRESIÓN ARTERIAL OSCILOMETRÍA FISIOLOGÍA ULTRASONOGRAFÍA |
| dc.title.none.fl_str_mv | Central-to-peripheral blood pressure amplification: role of the recording site, technology, analysis approach, and calibration scheme in invasive and non-invasive data agreement |
| dc.type.es.fl_str_mv | Artículo |
| dc.type.none.fl_str_mv | info:eu-repo/semantics/article |
| dc.type.version.none.fl_str_mv | info:eu-repo/semantics/publishedVersion |
| description | Background: Systolic blood pressure amplification (SBPA) and pulse pressure amplification (PPA) can independently predict cardiovascular damage and mortality. A wide range of methods are used for the non-invasive estimation of SBPA and PPA. The most accurate non-invasive method for obtaining SBPA and/or PPA remains unknown. Aim: This study aims to evaluate the agreement between the SBPA and PPA values that are invasively and non-invasively obtained using different (1) measurement sites (radial, brachial, carotid), (2) measuring techniques (tonometry, oscillometry/plethysmography, ultrasound), (3) pulse waveform analysis approaches, and (4) calibration methods [systo-diastolic vs. approaches using brachial diastolic and mean blood pressure (BP)], with the latter calculated using different equations or measured by oscillometry. Methods: Invasive aortic and brachial pressure (catheterism) and non-invasive aortic and peripheral (brachial, radial) BP were simultaneously obtained from 34 subjects using different methodologies, analysis methods, measuring sites, and calibration methods. SBPA and PPA were quantified. Concordance correlation and the Bland-Altman analysis were performed. Results: (1) In general, SBPA and PPA levels obtained with non-invasive approaches were not associated with those recorded invasively. (2) The different non-invasive approaches led to (extremely) dissimilar results. In general, non-invasive measurements underestimated SBPA and PPA; the higher the invasive SBPA (or PPA), the greater the underestimation. (3) None of the calibration schemes, which considered non-invasive brachial BP to estimate SBPA or PPA, were better than the others. (4) SBPA and PPA levels obtained from radial artery waveform analysis (tonometry) (5) and common carotid artery ultrasound recordings and brachial artery waveform analysis, respectively, minimized the mean errors. Conclusions: Overall, the findings showed that (i) SBPA and PPA indices are not "synonymous" and (ii) non-invasive approaches would fail to accurately determine invasive SBPA or PPA levels, regardless of the recording site, analysis, and calibration methods. Non-invasive measurements generally underestimated SBPA and PPA, and the higher the invasive SBPA or PPA, the higher the underestimation. There was not a calibration scheme better than the others. Consequently, our study emphasizes the strong need to be critical of measurement techniques, to have methodological transparency, and to have expert consensus for non-invasive assessment of SBPA and PPA. |
| eu_rights_str_mv | openAccess |
| format | article |
| id | COLIBRI_15f76fc815acd22e484e1e01d35ac78c |
| identifier_str_mv | Zócalo Y, Bia D, Sánchez R y otros. Central-to-peripheral blood pressure amplification: role of the recording site, technology, analysis approach, and calibration scheme in invasive and non-invasive data agreement. Frontiers in Cardiovascular Medicine [en línea]. 2023;10. 19 p. 10.3389/fcvm.2023.1256221 2297-055X |
| instacron_str | Universidad de la República |
| institution | Universidad de la República |
| instname_str | Universidad de la República |
| language | eng |
| language_invalid_str_mv | en |
| network_acronym_str | COLIBRI |
| network_name_str | COLIBRI |
| oai_identifier_str | oai:colibri.udelar.edu.uy:20.500.12008/54324 |
| publishDate | 2023 |
| reponame_str | COLIBRI |
| repository.mail.fl_str_mv | karina.camps@seciu.edu.uy |
| repository.name.fl_str_mv | COLIBRI - Universidad de la República |
| repository_id_str | 4771 |
| rights_invalid_str_mv | Licencia Creative Commons Atribución (CC - By 4.0) |
| spelling | Zócalo Yanina, Universidad de la República (Uruguay). Facultad de Medicina. Departamento de FisiologíaBia Daniel, Universidad de la República (Uruguay). Facultad de Medicina. Departamento de FisiologíaSánchez Ramiro, Fundación Favaloro (Argentina). Hospital UniversitarioLev Gustavo, Fundación Favaloro (Argentina). Hospital UniversitarioMendiz Oscar, Fundación Favaloro (Argentina). Hospital UniversitarioRamírez Agustín, Consejo Nacional de Investigaciones Científicas y Técnicas (Argentina). Instituto de Medicina Traslacional, Trasplante y BioingenieríaCabrera-Fischer Edmundo I., Consejo Nacional de Investigaciones Científicas y Técnicas (Argentina). Instituto de Medicina Traslacional, Trasplante y Bioingeniería2026-04-13T17:38:33Z2026-04-13T17:38:33Z2023Zócalo Y, Bia D, Sánchez R y otros. Central-to-peripheral blood pressure amplification: role of the recording site, technology, analysis approach, and calibration scheme in invasive and non-invasive data agreement. Frontiers in Cardiovascular Medicine [en línea]. 2023;10. 19 p.https://hdl.handle.net/20.500.12008/5432410.3389/fcvm.2023.12562212297-055XBackground: Systolic blood pressure amplification (SBPA) and pulse pressure amplification (PPA) can independently predict cardiovascular damage and mortality. A wide range of methods are used for the non-invasive estimation of SBPA and PPA. The most accurate non-invasive method for obtaining SBPA and/or PPA remains unknown. Aim: This study aims to evaluate the agreement between the SBPA and PPA values that are invasively and non-invasively obtained using different (1) measurement sites (radial, brachial, carotid), (2) measuring techniques (tonometry, oscillometry/plethysmography, ultrasound), (3) pulse waveform analysis approaches, and (4) calibration methods [systo-diastolic vs. approaches using brachial diastolic and mean blood pressure (BP)], with the latter calculated using different equations or measured by oscillometry. Methods: Invasive aortic and brachial pressure (catheterism) and non-invasive aortic and peripheral (brachial, radial) BP were simultaneously obtained from 34 subjects using different methodologies, analysis methods, measuring sites, and calibration methods. SBPA and PPA were quantified. Concordance correlation and the Bland-Altman analysis were performed. Results: (1) In general, SBPA and PPA levels obtained with non-invasive approaches were not associated with those recorded invasively. (2) The different non-invasive approaches led to (extremely) dissimilar results. In general, non-invasive measurements underestimated SBPA and PPA; the higher the invasive SBPA (or PPA), the greater the underestimation. (3) None of the calibration schemes, which considered non-invasive brachial BP to estimate SBPA or PPA, were better than the others. (4) SBPA and PPA levels obtained from radial artery waveform analysis (tonometry) (5) and common carotid artery ultrasound recordings and brachial artery waveform analysis, respectively, minimized the mean errors. Conclusions: Overall, the findings showed that (i) SBPA and PPA indices are not "synonymous" and (ii) non-invasive approaches would fail to accurately determine invasive SBPA or PPA levels, regardless of the recording site, analysis, and calibration methods. Non-invasive measurements generally underestimated SBPA and PPA, and the higher the invasive SBPA or PPA, the higher the underestimation. There was not a calibration scheme better than the others. Consequently, our study emphasizes the strong need to be critical of measurement techniques, to have methodological transparency, and to have expert consensus for non-invasive assessment of SBPA and PPA.Submitted by Almiñana María Cecilia (marialminana@gmail.com) on 2026-04-10T12:57:29Z No. of bitstreams: 2 license_rdf: 25630 bytes, checksum: e7132498e7c1fe99f7096667baa99b25 (MD5) Central-to-peripheral blood pressure amplification.pdf: 36345390 bytes, checksum: 6f439bf532eeffb21c4e483dffef1b32 (MD5)Approved for entry into archive by Almiñana María Cecilia (marialminana@gmail.com) on 2026-04-10T14:12:13Z (GMT) No. of bitstreams: 2 license_rdf: 25630 bytes, checksum: e7132498e7c1fe99f7096667baa99b25 (MD5) Central-to-peripheral blood pressure amplification.pdf: 36345390 bytes, checksum: 6f439bf532eeffb21c4e483dffef1b32 (MD5)Made available in DSpace by Luna Fabiana (fabiana.luna@seciu.edu.uy) on 2026-04-13T17:38:33Z (GMT). No. of bitstreams: 2 license_rdf: 25630 bytes, checksum: e7132498e7c1fe99f7096667baa99b25 (MD5) Central-to-peripheral blood pressure amplification.pdf: 36345390 bytes, checksum: 6f439bf532eeffb21c4e483dffef1b32 (MD5) Previous issue date: 202319 p.application/pdfenengFrontiers MediaFrontiers in Cardiovascular Medicine. 2023;10Las obras depositadas en el Repositorio se rigen por la Ordenanza de los Derechos de la Propiedad Intelectual de la Universidad de la República.(Res. Nº 91 de C.D.C. de 8/III/1994 – D.O. 7/IV/1994) y por la Ordenanza del Repositorio Abierto de la Universidad de la República (Res. Nº 16 de C.D.C. de 07/10/2014)info:eu-repo/semantics/openAccessLicencia Creative Commons Atribución (CC - By 4.0)Applanation tonometryCalibrationCentral-to-peripheral blood pressure amplificationInvasive recordsNon-invasive recordsOscillometryPhysiologyVascular ultrasoundTONOMETRÍA OCULARCALIBRACIÓNPRESIÓN ARTERIALOSCILOMETRÍAFISIOLOGÍAULTRASONOGRAFÍACentral-to-peripheral blood pressure amplification: role of the recording site, technology, analysis approach, and calibration scheme in invasive and non-invasive data agreementArtículoinfo:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionreponame:COLIBRIinstname:Universidad de la Repúblicainstacron:Universidad de la RepúblicaZócalo, YaninaBia, DanielSánchez, RamiroLev, GustavoMendiz, OscarRamírez, AgustínCabrera-Fischer, Edmundo I.LICENSElicense.txtlicense.txttext/plain; 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- Universidad de la Repúblicafalse |
| spellingShingle | Central-to-peripheral blood pressure amplification: role of the recording site, technology, analysis approach, and calibration scheme in invasive and non-invasive data agreement Zócalo, Yanina Applanation tonometry Calibration Central-to-peripheral blood pressure amplification Invasive records Non-invasive records Oscillometry Physiology Vascular ultrasound TONOMETRÍA OCULAR CALIBRACIÓN PRESIÓN ARTERIAL OSCILOMETRÍA FISIOLOGÍA ULTRASONOGRAFÍA |
| status_str | publishedVersion |
| title | Central-to-peripheral blood pressure amplification: role of the recording site, technology, analysis approach, and calibration scheme in invasive and non-invasive data agreement |
| title_full | Central-to-peripheral blood pressure amplification: role of the recording site, technology, analysis approach, and calibration scheme in invasive and non-invasive data agreement |
| title_fullStr | Central-to-peripheral blood pressure amplification: role of the recording site, technology, analysis approach, and calibration scheme in invasive and non-invasive data agreement |
| title_full_unstemmed | Central-to-peripheral blood pressure amplification: role of the recording site, technology, analysis approach, and calibration scheme in invasive and non-invasive data agreement |
| title_short | Central-to-peripheral blood pressure amplification: role of the recording site, technology, analysis approach, and calibration scheme in invasive and non-invasive data agreement |
| title_sort | Central-to-peripheral blood pressure amplification: role of the recording site, technology, analysis approach, and calibration scheme in invasive and non-invasive data agreement |
| topic | Applanation tonometry Calibration Central-to-peripheral blood pressure amplification Invasive records Non-invasive records Oscillometry Physiology Vascular ultrasound TONOMETRÍA OCULAR CALIBRACIÓN PRESIÓN ARTERIAL OSCILOMETRÍA FISIOLOGÍA ULTRASONOGRAFÍA |
| url | https://hdl.handle.net/20.500.12008/54324 |