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Brachial artery tonometry and the Popeye phenomenon
- Source :
- Journal of Hypertension. 30:1540-1551
- Publication Year :
- 2012
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2012.
-
Abstract
- BACKGROUND Noninvasive applanation tonometry studies of the brachial and radial artery pressure waves show that the arterial pulse is substantially amplified between the brachial and radial sites. Brachial tonometry waveforms have also been used to calibrate carotid tonometry waves as a measure of central pressure in major clinical trials. These trials assume identity of mean and of DBP in calculation of central (carotid) SBP. None of these trials showed superiority of central over brachial pressure in predicting outcome, but all showed equivalence of SBP and pulse pressure at brachial and carotid sites! METHOD We tested this method by measuring pressure waves at brachial, radial and carotid sites by applanation tonometry in 100 patients, with attention to any subtle difference between brachial and radial waveforms, and with both calibrated to cuff SBP and DBP. RESULTS The results confirmed no proximal and strong distal amplification in the arm. However, this was accompanied by blunting of the brachial compared with radial waveform with brachial pressure 2.7 mmHg higher during most of the cardiac cycle. Form factor of the ensemble-averaged brachial wave [39.1 standard deviation (SD) 4.9%] was similar to the carotid (40.2 SD 4.1%) but different to the radial wave (34.8 SD 3.7%; P < 0.01). CONCLUSIONS All findings were explained by inability to applanate the brachial artery, and resulting systematic error in generating brachial waveforms. In estimation of central pressure with applanation tonometry, the radial pressure wave, which can be accurately applanated, should be used, and calibrated to the brachial cuff. (No funders listed)
- Subjects :
- Adult
Male
Applanation tonometry
medicine.medical_specialty
Brachial Artery
Manometry
Physiology
Blood Pressure
Young Adult
Pressure waveform
Internal medicine
medicine.artery
Internal Medicine
medicine
Humans
Ankle Brachial Index
cardiovascular diseases
Brachial artery
Radial artery
Aged
Aged, 80 and over
Cardiac cycle
business.industry
Reproducibility of Results
Middle Aged
Pulse pressure
body regions
Forearm
Carotid Arteries
medicine.anatomical_structure
Anesthesia
Radial Artery
Cuff
cardiovascular system
Cardiology
Upper limb
Female
Cardiology and Cardiovascular Medicine
business
Blood Flow Velocity
circulatory and respiratory physiology
Subjects
Details
- ISSN :
- 02636352
- Volume :
- 30
- Database :
- OpenAIRE
- Journal :
- Journal of Hypertension
- Accession number :
- edsair.doi.dedup.....fc7aa07183fff7bd7da4967725c6c838