Correlation between Three Methods of Blood Pressure Measurement (Impedance Cardiography, Sphygmomanometry, and Invasive Methods)
Abstract
Aims and Objectives: The aims of the study were to find out the correlation between three methods of blood pressure (BP) measurement with impedance cardiography (ICG) device, conventional non-invasive sphygmomanometer, and cath lab-based invasive arterial pressure (AP) study.
Patients Materials and Methods: Patients who had definite indications for coronary angiography (CAG) or coronary intervention due to cardiac reasons were selected for the measurement of BP by three methods, namely, by transducer-based invasive central aortic pressure study, by ICG, and by conventional sphygmomanometry. One hundred patients of acute myocardial infarction having chest pain, ST elevation in two or more contiguous leads of electrocardiogram (ECG), biomarker positivity, and echocardiographic evidence of regional wall motion abnormality were selected. Transfemoral or radial access of the ascending aorta allowed the measurement of central aortic pressure during invasive procedure. CAG was done in the cath lab having “Siemens™ Axiom Artis Zee (floor)” equipment. The subjects who were unwilling to participate, who were moribund, critically ill subjects, and patients with concomitant heart failure, arrhythmia, and valvular lesions were excluded from the study. GE™ Vivid 7 Dimension machine was used for ECG-gated echo-Doppler studies. ICG-derived BP values (systolic BP [SBP], diastolic BP [DBP], mean AP [MAP], and pulse pressure) were recorded for comparison with similar pressure data obtained from two other methods.
Results and Analysis: Analysis of results show a comparison of data on SBP, DBP, and MAP measured by three methods by sphygmomanometry, invasive, and ICG methods. The analysis also shows the values of correlation coefficients – all of which are significantly positive correlations. ICG has been found to have positive correlation with both sphygmomanometric and invasive methods of BP measurement. It also shows a graphical presentation of the correlation between SBP, DBP, and MAP measured by three methods by sphygmomanometry, invasive, and ICG methods.
Conclusion: There is a significant correlation between three methods of BP measurement with ICG device, conventional non-invasive sphygmomanometer-based method, and cath lab-based invasive AP study.
References
Estimation of echocardiogram parameters with the aid of impedance
cardiography and artificial neural networks. Artif Intell Med 2019;96:45-58.
2. Ghosh S, Chattopadhyay BP, Roy RM, Mukhopadhyay J, Mahadevappa M.
Stroke volume, ejection fraction and cardiac health monitoring
using impedance cardiography. Conf Proc IEEE Eng Med Biol Soc
2018;2018:4229-32.
3. Kubicek WG, Karnegis JN, Patterson RP, Witsoe DA, Mattson RH.
Development and evaluation of an impedance cardiac output system.
Aerosp Med 1966;37:1208-12.
4. Nyboer J, Kreider MM, Hannapel L. Electrical impedance plethysmography.
Circulation 1950;l2:811-21.
5. Wilenius M, Tikkakoski AJ, Tahvanainen AM, Haring A, Koskela J,
Huhtala H, et al. Central wave reflection is associated with peripheral
arterial resistance in addition to arterial stiffness in subjects without
antihypertensive medication. BMC Cardiovasc Disord 2016;16:131.
6. Ito H, Yamakoshi KI, Togawa T. A model study of stroke volume values
calculated from impedance and their relation to the waveform of blood flow.
IEEE Trans Biomed Eng 1977;24:489-91.
7. Weber T, Auer J, O’Rourke MF, Kvas E, Lassnig E, Berent R, et al.
Arterial stiffness, wave reflections, and the risk of coronary artery disease.
Circulation 2004;109:184-9.
8. Marchais SJ, Guerin AP, Pannier BM, Levy BI, Safar ME, London GM.
Wave reflections and cardiac hypertrophy in chronic uremia. Influence of
body size. Hypertension 1993;22:876-83.
9. Tsioufis C, Tzioumis C, Marinakis N, Toutouzas K, Tousoulis D,
Kallikazaros I, et al. Microalbuminuria is closely related to impaired
arterial elasticity in untreated patients with essential hypertension. Nephron
Clin Pract 2003;93:c106-11.
10. Rema M, Mohan V, Deepa R, Ravikumar R, Chennai Urban Rural
Epidemiology Study-2. Association of carotid intima-media thickness
and arterial stiffness with diabetic retinopathy: The Chennai Urban rural
epidemiology study (CURES-2). Diabetes Care 2004;27:1962-7.
11. Qureshi G, Brown R, Salciccioli L, Qureshi M, Rizvi S, Farhan S, et al.
Relationship between aortic atherosclerosis and non-invasive measures of
arterial stiffness. Atherosclerosis 2007;195:e190-4.
12. Williams B, Lacy PS, Thom SM, Cruickshank K, Stanton A, Collier D,
et al. Differential impact of blood pressure-lowering drugs on central aortic
pressure and clinical outcomes: Principal results of the conduit artery
function evaluation (CAFE) study. Circulation 2006;113:1213-25.
13. Weber T, Auer J, O’rourke MF, Kvas E, Lassnig E, Lamm G, et al.
Increased arterial wave reflections predict severe cardiovascular events
in patients undergoing percutaneous coronary interventions. Eur Heart J
2005;26:2657-63.
14. London GM, Blacher J, Pannier B, Guérin AP, Marchais SJ, Safar ME.
Arterial wave reflections and survival in end-stage renal failure.
Hypertension 2001;38:434-8.