Pulse Arrival Time Segmentation Into Cardiac and Vascular Intervals - Implications for Pulse Wave Velocity and Blood Pressure Estimation

Fabian Beutel*, Chris Van Hoof, Xavier Rottenberg, Koen Reesink, Evelien Hermeling

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

5 Citations (Web of Science)

Abstract

Objective: This study demonstrates a novel method for pulse arrival time (PAT) segmentation into cardiac isovolumic contraction (IVC) and vascular pulse transit time to approximate central pulse wave velocity (PWV). Methods: 10 subjects (38 +/- 10 years, 121 +/- 12 mmHg SBP) ranging from normotension to hypertension were repeatedly measured at rest and with induced changes in blood pressure (BP), and thus PWV. ECG was recorded simultaneously with ultrasound-based carotid distension waveforms, a photoplethysmography-based peripheral waveform, noninvasive continuous and intermittent cuff BP. Central PAT was segmented into cardiac and vascular time intervals using a fiducial point in the carotid distension waveform that reflects the IVC onset. Central and peripheral PWVs were computed from (segmented) intervals and estimated arterial path lengths. Correlations with Bramwell-Hill PWV, systolic and diastolic BP (SBP/DBP) were analyzed by linear regression. Results: Central PWV explained more than twice the variability (R-2) in Bramwell-Hill PWV compared to peripheral PWV (0.56 vs. 0.27). SBP estimated from central PWV undercuts the IEEE mean absolute deviation threshold of 5 mmHg, significantly lower than peripheral PWV or PAT (4.2 vs. 7.1 vs. 10.1 mmHg). Conclusion: Cardiac IVC onset signaled in carotid distension waveforms enables PAT segmentation to obtain unbiased vascular pulse transit time. Corresponding PWV estimates provide the basis for single-site assessment of central arterial stiffness, confirmed by significant correlations with Bramwell-Hill PWV and SBP. Significance: In a small-scale cohort, we present proof-of-concept for a novel method to estimate central PWV and BP, bearing potential to improve the practicality of cardiovascular risk assessment in clinical routines.

Original languageEnglish
Pages (from-to)2810-2820
Number of pages11
JournalIeee Transactions on Biomedical Engineering
Volume68
Issue number9
DOIs
Publication statusPublished - Sep 2021

Keywords

  • Electrocardiography
  • Ultrasonic imaging
  • Blood pressure
  • Estimation
  • Biomedical measurement
  • Matlab
  • Hypertension
  • Algorithms
  • biomarkers
  • biomedical signal processing
  • biomedical transducers
  • electrocardiography
  • patient monitoring
  • sensor fusion
  • ultrasonography
  • ARTERIAL STIFFNESS
  • TRANSIT-TIME
  • TASK-FORCE
  • HYPERTENSION
  • DETERMINANTS
  • CONTRACTION
  • MANAGEMENT
  • DEPENDENCE
  • MARKER
  • MOTION

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