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 - Bia, Daniel - Sánchez, Ramiro - Lev, Gustavo - Mendiz, Oscar - Ramírez, Agustín - Cabrera-Fischer, Edmundo I.

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.

Detalles Bibliográficos
2023
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
Inglés
Universidad de la República
COLIBRI
https://hdl.handle.net/20.500.12008/54324
Acceso abierto
Licencia Creative Commons Atribución (CC - By 4.0)
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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
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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
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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
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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