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J Am Coll Cardiol, 1998; 32:1214-1220
© 1998 by the American College of Cardiology Foundation
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Use of radial artery applanation tonometry and a generalized transfer function to determine aortic pressure augmentation in subjects with treated hypertension

James D. Cameron, MD, MEngSc* {dagger}, Barry P. McGrath, MD{ddagger} and Anthony M. Dart, DPhil, MB, BCh{dagger}

* La Trobe University, Melbourne, Victoria, Australia
{dagger} Baker Medical Research Institute, Melbourne, Victoria, Australia
{ddagger} Monash University Department of Medicine, Monash Medical Centre, Melbourne, Victoria, Australia



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  		Figure 1 Illustration of AP and inflection points used in analysis. P1, P2 and Pd, are the BP at the first and second shoulders and at end diastole, respectively.

In the current version of the PWV Medical SphygmoCor device, AI as defined here is labeled as AIP2/P1. If the reported AI is greater than 100, then P2 > P1, that is the pressure at the second systolic shoulder, is greater than at the first. In terms of the classification of Murgo et al. (17), this corresponds to a type "A" waveform, whereas if P2 < P1, a type "C" waveform results. Kelly et al. (2) calculated AI as AI = (P1 – P2)/{Delta}P, that is, AP divided by pulse pressure. This formula gives both positive and negative values of AI.

 


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  		Figure 2 Univariate association (95% confidence interval of the line and 95% prediction interval) of AI and AP with heart rate and age.

 


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  		Figure 3 Linear regression of central aortic AI with heart rate (top panel) and DBP (lower panel) for males (solid circle, dashed line) and females (open circle, solid line) analyzed separately. The regression equations are:

 


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  		Figure 4 Combined regression line for the ACE inhibitor, calcium channel blocker and diuretic groups (95% confidence and prediction intervals shown) with beta-blocker group (solid circles) superimposed.

 


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  		Figure 5 Upper three panels, comparison of derived central pressures versus measured brachial pressures. Lower three panels, error plots (mean difference and 95% confidence intervals) of the comparisons.

 




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Copyright © 1998 by the American College of Cardiology Foundation.