Non-Invasive Monitoring of Central Blood Pressure in Humans

人体中心血压的无创监测

• 批准号: 8454415
• 负责人: RAMAKRISHNA MUKKAMALA
• 金额: $ 7.25万
• 依托单位: MICHIGAN STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-04-15 至 2015-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8454415
• 关键词: Accounting; Age; Aging; Agreement; Animal Testing; Animals; Blood Pressure; Blood Pressure Monitors; Blood flow; Catheterization; Clinical; Data; Data Collection; Diastole; Hand; Health; Heart; Human; Institution; Lead; Measurement; Measures; Medical; Methods; Noise; Patients; Peripheral Resistance; Physiological; Pulse Pressure; Relative (related person); Severity of illness; Speed; Systolic Pressure; Techniques; Testing; Time; Trees; Universities; Update; Validation; age related; base; clinical practice; follow-up; improved; interest; non-invasive monitor; peripheral blood; physiologic model; prospective

DESCRIPTION (provided by applicant): Central blood pressure (BP) is physiologically and clinically more relevant than peripheral BP, especially in aging. However, peripheral BP waveforms can be measured more safely via catheterization and even non-invasively. The broad objective of this project is to establish a technique for mathematically deriving a central BP waveform from a peripheral BP waveform. While such techniques have been developed in the past, they are based on the assumption that a single, universal transfer function exists that can faithfully relate a peripheral BP waveform to a central BP waveform of any subject over any physiologic condition. These "generalized transfer functions" (GTF) techniques therefore do not adapt to the inter-subject and temporal variability of the arterial tree due to, for example, age-related arterial compliance differences and neuro-humoral modulation of peripheral resistance and are consequently prone to serious central BP error. In this project, a new technique, which is able to adapt the transfer function relating peripheral BP to central BP to the arterial parameters of the subject at the time of measurement by exploiting the fact that ascending aortic blood flow is negligible during diastole, will be rigorously investigated in humans as a follow-up to successful animal testing. The specific aims are: (1) to optimize the adaptive transfer function (ATF) technique for application in humans; (2) to broadly validate the technique in humans; and (3) to demonstrate that the technique is superior to previous techniques in humans. To accomplish these specific aims, existing data comprising non-invasive peripheral BP waveforms for analysis and reference central BP waveforms from a large number of diverse subjects under multiple physiologic conditions will be analyzed. A portion of the data will be used to maximize the accuracy of the ATF technique and enhance it in other ways including augmenting its computational speed. These data will likewise be used to optimize GTF techniques and other previous, related techniques. The remaining data will be used to evaluate the techniques in terms of accuracy and clinical value of the derived central BP as well as robustness to actual noise in the analyzed peripheral BP waveforms. Statistical comparisons will then be performed to establish the relative capabilities and any limitations of the ATF technique. Successful completion of this project will be followed by prospective patient testing of the ATF technique and may ultimately lead to improved BP monitoring in clinical practice.

描述（由申请人提供）：中央血压（BP）在生理和临床上比外周BP更相关，尤其是在衰老中。但是，外围BP波形可以通过导管插入术，甚至是非侵入性的。该项目的广泛目的是建立一种从数学上从外围BP波形得出中央BP波形的技术。尽管过去已经开发了此类技术，但它们基于以下假设：存在单个通用传递函数，可以忠实地将外围BP波形与任何生理条件上任何受试者的中央BP波形联系起来。因此，这些“广义转移函数”（GTF）技术不适应动脉树间和时间变化，例如，与年龄相关的动脉依从性差异和神经幽默的外周耐药性调制，因此很容易发生严重的中枢BP误差。在该项目中，一种新技术，能够在测量时通过利用这一事实来调整将外周BP与中央BP与中央BP相关的中央BP与受试者的动脉参数，以免在舒张期间升高的主动脉血流可忽略不计，而在人类中将在人类中被严格研究。具体目的是：（1）优化用于人类应用的自适应传递函数（ATF）技术； （2）广泛验证人类的技术； （3）证明该技术优于人类以前的技术。为了实现这些特定目标，将分析包括非侵入性外围BP波形的现有数据，用于分析和参考来自多种生理条件下大量不同受试者的中央BP波形。一部分数据将用于最大化ATF技术的准确性，并以其他方式增强它，包括提高其计算速度。这些数据同样将用于优化GTF技术和其他以前的相关技术。其余数据将用于评估派生的中央BP的准确性和临床值以及在分析的外围BP波形中对实际噪声的鲁棒性。然后将进行统计比较，以建立ATF技术的相对能力和任何局限性。该项目的成功完成将进行预期的ATF技术测试，并最终可能会改善临床实践中的BP监测。