[PP.LB03.12] ASSESSMENT OF SYSTOLIC AORTIC PRESSURE AND WAVE FORM CALIBRATION CRITICALLY DEPENDS ON THE ACCURATE DETERMINATION OF MEAN ARTERIAL PRESSURE: A CASE REPORT

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Abstract

Objective:

Therefore the aim of this work is the analysis of different MAP estimation methods and its impact on derived aSBP values.

Methods:

In a series of eight patients we retrospectively compared aSBP as assessed with the Complior® device with aSBP provided with a validated oscillometric device using a generalized transfer function (ARCSolver®, Mobil-O-Graph®). aSBP was determined for clinical indications in patients (age: 64+9.9, sex:2 female, 6 male)with arterial hypertension or coronary artery disease. In the case of the Complior® device the wave form calibration was based on determination of calculated mean pressure (MAP1) and diastolic pressures as assessed with a validated oscillometric device. In the case of the Mobil-O-Graph® measured mean (MAP2) and diastolic pressures were used for wave form calibration. Furthermore, measured mean and diastolic pressures of the Mobil-O-Graph® were used for assessment of aSBP in the Complior® device.

Design and method:

As expected peripheral values of SBP and DBP where the same for both oscillometric devices (128+ 8.7/77.5+12.7 mmHg vs 127.9+7.0/78.1+12.5 mmHg; ns). Nevertheless as depicted in the figure striking differences for aSBP were observed between the Complior® device and the Mobil-O-Graph® (99.4+11.0 vs 139.3+8.4 mmHg; p = 0,000017) depending on the calibration.

Design and method:

Simliarly as shown in the figure we observed a difference of 15 mmHg for the two oscillometric devices between MAP1 and MAP2 (86.3+ 9.9 vs 101.0+ 8.3 mmHg,; p = 0,00006).

Design and method:

If we used the measured mean (MAP2) and diastolic pressures of the Mobil-O-Graph® for calibration of the Complior® device as well the differences for aSBP diminished significantly (133.7+ 10.6 vs 139.3 +8.4mmHg for Complior® and Mobil-O-Graph® respectively; ns).

Results:

The assessment on aSBP critically affects absolute aSBP values reported to the physician. If the same calibration method is used, different results between devices diminish. With respect to clinical practice and thresholds standardization of MAP definition is indicated.

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