An adaptive transfer function for deriving the aortic pressure waveform from a peripheral artery pressure waveform

Am J Physiol Heart Circ Physiol. 2009 Nov;297(5):H1956-63. doi: 10.1152/ajpheart.00155.2009. Epub 2009 Sep 25.

Abstract

We developed a new technique to mathematically transform a peripheral artery pressure (PAP) waveform distorted by wave reflections into the physiologically more relevant aortic pressure (AP) waveform. First, a transfer function relating PAP to AP is defined in terms of the unknown parameters of a parallel tube model of pressure and flow in the arterial tree. The parameters are then estimated from the measured PAP waveform along with a one-time measurement of the wave propagation delay time between the aorta and peripheral artery measurement site (which may be accomplished noninvasively) by exploiting preknowledge of aortic flow. Finally, the transfer function with its estimated parameters is applied to the measured waveform so as to derive the AP waveform. Thus, in contrast to the conventional generalized transfer function, the transfer function is able to adapt to the intersubject and temporal variability of the arterial tree. To demonstrate the feasibility of this adaptive transfer function technique, we performed experiments in 6 healthy dogs in which PAP and reference AP waveforms were simultaneously recorded during 12 different hemodynamic interventions. The AP waveforms derived by the technique showed agreement with the measured AP waveforms (overall total waveform, systolic pressure, and pulse pressure root mean square errors of 3.7, 4.3, and 3.4 mmHg, respectively) statistically superior to the unprocessed PAP waveforms (corresponding errors of 8.6, 17.1, and 20.3 mmHg) and the AP waveforms derived by two previously proposed transfer functions developed with a subset of the same canine data (corresponding errors of, on average, 5.0, 6.3, and 6.7 mmHg).

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Animals
  • Aorta / drug effects
  • Aorta / physiology*
  • Blood Pressure Determination / methods*
  • Blood Pressure* / drug effects
  • Cardiac Pacing, Artificial
  • Cardiovascular Agents / pharmacology
  • Carotid Arteries / drug effects
  • Carotid Arteries / physiology*
  • Computer Simulation*
  • Dogs
  • Feasibility Studies
  • Femoral Artery / drug effects
  • Femoral Artery / physiology*
  • Heart Rate
  • Models, Cardiovascular*
  • Pulsatile Flow
  • Regional Blood Flow
  • Reproducibility of Results
  • Signal Processing, Computer-Assisted*

Substances

  • Cardiovascular Agents