Outlook for ergometer testing with beat to beat blood pressure measurement

Abstract

Objective. The article discusses the advantages of performing stress tests with pressure control at each heartbeat. The question of increasing accuracy, informativeness and safety of the test is considered. Materials and methods. We performed 30 bicycle ergometric tests with ECG measurement, beat to beat blood pressure measurement and periodic blood pressure measurement by the Korotkoff method in the shoulder. Results. It was shown that arterial pressure registered by Korotkoff sounds in the shoulder corresponded with continuous pressure at the registration moment. Because of the impossibility to measure the dynamics, the underestimation of maximum systolic arterial pressure by the Korotkoff method exceeds 20 mm Hg in every 3 tests, and exceeds 30 mm Hg in every 5 tests. Therefore, the beat to beat measurement of BP significantly improves the accuracy and informativeness value of stress tests. Conclusions. Continuous BP signal in the finger increases reliability of noisy Korotkoff sounds extraction and the results of BP measurement in the shoulder by the classical method. The increased accuracy and reliability of the measurement provides greater patient safety. Continuous pressure corrected by Korotkoff sounds during reference measurements in the shoulder gives a detailed and accurate picture of BP variations, which allows to investigate in detail features of the patient’s cardiovascular system regulation, both during and after the load, which is not available with classical BP measurement.