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Evaluation of Pulse Arrival Time Model to Estimate Systolic Blood Pressure during Exercise
Author(s) -
Hedge Eric T.,
Amelard Robert,
Hughson Richard L.
Publication year - 2020
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.2020.34.s1.05902
Subject(s) - photoplethysmogram , blood pressure , medicine , limits of agreement , pulse pressure , pulse (music) , linear regression , cardiology , arrival time , heart rate , mathematics , statistics , nuclear medicine , computer science , telecommunications , filter (signal processing) , detector , transport engineering , engineering , computer vision
Pulse arrival time (PAT) is a method used to estimate systolic blood pressure (SBP), as the amount of time it takes for a pulse to travel from the heart to a peripheral location is inversely related to blood pressure. However, the validity and accuracy of this method’s blood pressure estimation has been questioned. Therefore, the purpose of this study was to evaluate the accuracy of a PAT model’s estimation of SBP over a range of exercise intensities. Six participants (5 men, 1 woman; age: 26 ± 4 yrs) completed three cycling exercise tests (25 Watt/min ramp incremental test, and moderate and heavy pseudorandom binary sequence exercise) during three separate laboratory visits. PAT was calculated as the time difference between the R‐wave of an electrocardiogram and the pulse arrival at the forehead measured with a pulse oximeter. SBP was estimated using the following equation: SBP PAT = 64.578/(PAT) – 43.957, and was compared to calibrated brachial blood pressure measured at the finger (FBP) by photoplethysmography during the exercise trials. Participant blood pressure responses were pooled, and Bland‐Altman analysis was conducted to evaluate the accuracy of estimated SBP for each exercise test. PAT model estimation of SBP had the smallest bias during heavy (−2.8 mmHg), then moderate (8.1 mmHg), and the largest bias during ramp incremental exercise (−11 mmHg), with their limits of agreement being between −56 and 50 mmHg, −29 and 45 mmHg, and −74 and 53 mmHg, respectively. Linear regression of the ramp incremental SBP response revealed that SBP estimated from the PAT does not increase by the same magnitude as the pressure measured at the finger (SBP PAT = 0.295 · SBP FBP + 106.236, r 2 = 0.350, p < 0.05). Overall, these findings support that SBP estimated by PAT is linearly related to brachial SBP measured at the finger; however, this PAT model is a poor estimator of absolute SBP during exercise ranging from moderate to maximal intensities. Support or Funding Information Supported by NSERC.