Although compelling evidence has established the physiological and clinical relevance of aortic SBP (a-SBP), no consensus exists regarding the validity of the available methods/techniques that noninvasively measure it.
The systematic review and meta-analysis aimed to determine the accuracy of commercial devices estimating a-SBP noninvasively, which have been validated by invasive measurement of a-SBP. Moreover their optimal mode of application, in terms of calibration, as well as specific technique and arterial site of pulse wave acquisition were further investigated.
The study was performed according to the PRISMA guidelines; 22 eligible studies were included, which validated invasively 11 different commercial devices in 808 study participants.
Overall, the error in a-SBP estimation (estimated minus actual value) was −4.49 mmHg [95% confidence interval (CI): −6.06 to −2.92 mmHg]. The estimated (noninvasive) a-SBP differed from the actual (invasive) value depending on calibration method: by −1.08 mmHg (95% CI: −2.81, 0.65 mmHg) and by −5.81 mmHg (95% CI: −7.79, −3.84 mmHg), when invasively and noninvasively measured brachial BP values were used respectively; by −1.83 mmHg, (95% CI: −3.32, −0.34 mmHg), and by 7.78 mmHg (95% CI: −10.28, −5.28 mmHg), when brachial mean arterial pressure/DBP and SBP/DBP were used, respectively.
Automated recording of waveforms, calibrated noninvasively by brachial mean arterial pressure/DBP values seems the most promising approach that can provide relatively more accurate, noninvasive estimation of a-SBP. It is still uncertain whether a specific device can be recommended as ‘gold standard’; however, a consensus is currently demanding.
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aBiomedical Engineering Unit, First Department of Cardiology, Hippokration Hospital
bDepartment of Hygiene, Epidemiology and Medical Statistics
cCardiovascular Prevention and Research Unit, Department of Pathophysiology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
dMenzies Institute for Medical Research, Tasmania, University of Tasmania, Hobart, Australia
eCardiology Department, Klinikum Wels-Grieskirchen, Wels, Austria
fFaculty of Medicine, Paris-Descartes University, Hôtel-Dieu Hospital, AP-HP, Diagnosis and Therapeutic Center, Paris, France
gDivisions of Internal Medicine and Experimental Medicine, Department of Medicine, McGill University, Montreal, Quebec, Canada
hAustrian Institute of Technology, Health & Environment Department, Vienna, Austria
iBrunel Institute for Bioengineering, Brunel University, Uxbridge, UK
jLaboratory of Hemodynamics and Cardiovascular Technology, Institute of Biotechnology, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
kSchool of Medicine, Yale University, New Haven, Connecticut
lDivision of Cardiovascular Medicine, University of Florida, Gainesville, Florida, USA
Correspondence to Theodore G. Papaioannou, Biomedical Engineering Unit, First Department of Cardiology, Medical School, Hippokration Hospital, Vas. Sophias 114, Athens 115 27, Greece. Tel: +30 213 2088286; fax: +30 213 2088676; e-mail: email@example.com
Abbreviations: a, aortic; br, brachial; BP, blood pressure; CAD, coronary artery disease; CI, confidence interval; MAP, mean arterial pressure
Received 18 September, 2015
Revised 26 December, 2015
Accepted 4 March, 2016
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