PS-C07-8: CENTRAL BLOOD PRESSURE ESTIMATION USING THE RADIAL ARTERIAL PRESSURE WAVEFORM IN CHILDREN, ADOLESCENTS, AND YOUNG ADULTS

Abstract

Objective: Evaluation of central blood pressure is useful in prevention and treatment of cardiovascular diseases. In this study, we examined the accuracy of non-invasively measured central blood pressure in children, adolescents, and young adults. Design and Method: This study enrolled 23 patients who had undergone a cardiac catheterization below 30 years old (10.4 ± 7.2 years, 16 males and 7 females). Ascending aortic blood pressure waveforms were invasively recorded using a pressure sensor-mounted catheter (model SPC-454D, Millar Instrument, Inc., Houston, Texas). Simultaneously, radial artery pulse waveforms were non-invasively recorded by tonometry (HEM-9000AI, Omron Healthcare Co., Ltd., Kyoto, Japan). The measurements were performed before and after angiogram (injection of contrast media) except for one case. We analyzed the degree of coincidence between ascending aortic systolic blood pressure (aSBP) and estimated central systolic blood pressure calculated by the instrument (estCBP) in 45 simultaneous recording of aSBP and estCBP. The HEM-9000AI calculates estCBP using rSBP2, which indicates reflected pressure on radial artery. Results: The aSBP was 96.2 ± 13.4 mmHg and estCBP was 92.9 ± 14.7mmHg. There was no significant correlation between the aSBPs before and after angiogram in the same case. There was a significant relationship between aSBP and estCBP (r = 0.83, p < 0.0001). The mean difference of the estSBP minus aSBP was -3.3 ± 8.3 mmHg by Bland-Altman analysis. The relationship between aSBP and rSBP1, which indicates forward pressure on radial artery, was stronger than the relationship between aSBP and rSBP2 (r = 0.88, p < 0.0001 vs. r = 0.83, p < 0.0001). The relationship between aSBP and the average of rSBP1 and rSBP2 (r = 0.90, p < 0.0001) was stronger than the relationship between aSBP and estCBP. Conclusions: The estSBP calculated using rSBP2 method by HEM 9000AI was significantly correlated to aSBP in children, adolescents, and young adults. However, the correlation coefficient between aSBP and rSBP2 was smaller than that between aSBP and rSBP1. The estCBP calculated by rSBP1 and rSBP2 was strongly correlated to aSBP rather than estCBP by rSBP2 alone.