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. 2017 May;35(5):1002-1010.
doi: 10.1097/HJH.0000000000001252.

Systolic peak foot-to-apex time interval, a novel oscillometric technique for systolic blood pressure measurement

Amir M Benmira  1 , Antonia Perez-Martin, Sarah Coudray, Iris Schuster, Isabelle Aichoun, Jérémy Laurent, Fethi Bereski-Reguig, Michel Dauzat
Affiliations

Systolic peak foot-to-apex time interval, a novel oscillometric technique for systolic blood pressure measurement

Amir M Benmira et al. J Hypertens. 2017 May.

Abstract

Background: Noninvasive blood pressure (BP) measurement is essential for the study of human physiology but automatic oscillometric devices only estimate SBP and DBP using various, undisclosed algorithms, precluding standardization and interchangeability. We propose a novel approach by tracking, during pneumatic cuff deflation, the time interval from the foot to the apex of the systolic peak of the oscillometric signal, which reaches a maximum concomitant with the first Korotkoff sound.

Method: In 145 study participants and patients (group 1), we measured the systolic brachial artery blood pressure by Korotkoff sound recording, conventional oscillometry, and our fully automated systolic peak foot-to-apex time interval (SFATI) technique. In 35 other patients (group 2), we compared SFATI with intra-arterial measurement.

Results: In group 1, the concordance correlation coefficient was 0.989 and 0.984 between SFATI and Korotkoff sounds, 0.884 and 0.917 between oscillometry and Korotkoff sounds, and 0.882 and 0.919 between SFATI and oscillometry, respectively, on the left and right arm. In group 2, it was 0.72 between SFATI and intra-arterial measurement, 0.67 between oscillometry and intra-arterial measurement, and 0.92 between SFATI and Korotkoff sounds. In 40 study participants, the reproducibility study yielded a concordance coefficient of 0.95 for SFATI and 0.94 for Korotkoff sounds.

Conclusion: SFATI BP measurement shows an excellent concordance with the auscultatory technique, offering a major improvement over current oscillometric techniques and allowing standardization.

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Figures

FIGURE 1
FIGURE 1
Korotkoff sounds, oscillometric pulse pressure waveform, and systolic peak foot-to-apex time interval (tf-a) changes during cuff deflation (from study participant #46). (a) Changes in tf-a at the appearance of Korotkoff sounds. (b): The Korotkoff sounds, the oscillometric pulse pressure waveform, the tf-a curve, and the cuff pressure during deflation. SBP is measured at the time of the first tf-a maximum. tf-a, time from the foot to the apex of the oscillometric waveform systolic peak.
FIGURE 2
FIGURE 2
Bland and Altman plot of SBP measurement by the different techniques (right arm). (a) Systolic peak apex delay technique (Pad1) vs. automatic reading of Korotkoff sounds (SBPK). (b) Oscillometry (SBPIA) vs. automatic reading of Korotkoff sounds (SBPK). (c) Pad1 vs. oscillometry (SBPIA). (d) Pad1 vs. direct intra-arterial measurement (SBPIA). Pad1, arm-cuff pressure corresponding to the first maximum of the systolic peak foot-to-apex time interval; SBP measured by radial artery catheter; SBPK, SBP measured by the auscultation technique.
FIGURE 3
FIGURE 3
Age of study participants without or with a second increase of the tf-a. Box and whiskers plots (the box limits are first to third percentile; the horizontal line is the median, the whiskers cover the range). tf-a, time from the foot to the apex of the oscillometric waveform systolic peak.
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References

    1. Campbell NR, Berbari AE, Cloutier L, Gelfer M, Kenerson JG, Khalsa TK, et al. Policy statement of the world hypertension league on noninvasive blood pressure measurement devices and blood pressure measurement in the clinical or community setting. J Clin Hypertens (Greenwich) 2014; 16:320–322. - PMC - PubMed
    1. Daskalopoulou SS, Rabi DM, Zarnke KB, Dasgupta K, Nerenberg K, Cloutier L, et al. The 2015 Canadian Hypertension Education Program recommendations for blood pressure measurement, diagnosis, assessment of risk, prevention, and treatment of hypertension. Can J Cardiol 2015; 31:549–568. - PubMed
    1. Weber MA, Schiffrin EL, White WB, Mann S, Lindholm LH, Kenerson JG, et al. Clinical practice guidelines for the management of hypertension in the community: a statement by the American Society of Hypertension and the International Society of Hypertension. J Clin Hypertens (Greenwich) 2014; 16:14–26. - PMC - PubMed
    1. O’Brien E, Atkins N, Stergiou G, Karpettas N, Parati G, Asmar R, et al. Working Group on Blood Pressure Monitoring of the European Society of Hypertension European Society of Hypertension International Protocol revision 2010 for the validation of blood pressure measuring devices in adults. Blood Press Monit 2010; 15:23–38. - PubMed
    1. Stergiou GS, Karpettas N, Atkins N, O’Brien E. European Society of Hypertension International Protocol for the validation of blood pressure monitors: a critical review of its application and rationale for revision. Blood Press Monit 2010; 15:39–48. - PubMed