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Noninvasive assessment of hemodynamics: a comparative analysis of fingertip pulse contour analysis and impedance cardiography

Sauder, Katherine A.a; Pokorney, Paige E.a; McCrea, Cindy E.a; Ulbrecht, Jan S.a; Kris-Etherton, Penny M.b; West, Sheila G.a,b

doi: 10.1097/MBP.0000000000000118
Analytical Methods and Statistical Analysis

Objective Systemic hemodynamic assessment is useful for characterizing the underlying physiology of hypertension, selecting individualized treatment approaches, and understanding the underlying mechanisms of action of interventions. Invasive methods are not suitable for routine clinic or research use, and noninvasive methods such as impedance cardiography have technical and practical limitations. Fingertip pulse contour analysis using the Nexfin device is a novel alternative to noninvasive assessment of blood pressure and hemodynamics. Although both impedance cardiography and the Nexfin have been validated against invasive methods, the extent to which they are correlated with each other is unknown. This study is a comparative analysis of data simultaneously obtained by impedance cardiography and using the Nexfin device.

Methods As part of a larger clinical trial, 13 adults with type 2 diabetes completed cardiovascular reactivity testing on three occasions: at study baseline and after two 4-week dietary treatment periods. Blood pressure, hemodynamics, and heart rate variability were assessed at rest and during acute mental stress.

Results Blood pressure, heart rate, and heart rate variability data were significantly correlated between the two devices, but hemodynamic data (stroke volume, cardiac output, total peripheral resistance) were not significantly correlated. Both techniques detected treatment-related changes in blood pressure and total peripheral resistance, but significantly differed in the magnitude and/or direction of treatment effects.

Conclusion We conclude that Nexfin is not an appropriate alternative to impedance cardiography for measurement of underlying hemodynamics in psychophysiological research, but may be useful for beat-to-beat monitoring of blood pressure and heart rate variability.

Departments of aBiobehavioral Health

bNutritional Sciences, The Pennsylvania State University, University Park, Pennsylvania, USA

Correspondence to Sheila G. West, PhD, Department of Biobehavioral Health, The Pennsylvania State University, 219 Biobehavioral Health Building, University Park, PA 16802, USA Tel: +1 814 863 0176; fax: +1 814 863 7525; e-mail:

Received October 31, 2014

Received in revised form January 27, 2015

Accepted February 19, 2015

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