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Using noninvasive adjusted pulse transit time for tracking beat-to-beat systolic blood pressure during ventricular arrhythmia

Hypertension Research volume 45, pages 424–435 (2022)Cite this article

A Comment to this article was published on 27 December 2021

Abstract

Tracking beat-to-beat blood pressure noninvasively during ventricular arrhythmia (VA) is of great importance but rarely reported. The goal of our study was to investigate the potential utility of the adjusted pulse transit time (APTT) to track beat-to-beat femoral systolic blood pressure (SBP) during VA. Patients who underwent radiofrequency ablation for arrhythmias at Fuwai Hospital were enrolled. Electrocardiograms (ECGs), finger photoplethysmograms, and femoral arterial blood pressure were recorded simultaneously during VA. The APTT was calculated as the ratio between the square of the conventional pulse transit time (cPTT) and the RR interval of the ECG waveform. Forty-five patients were enrolled in our study, and 22,849 beats were collected during their VA. The inverse of the APTT showed a good correlation with femoral SBP during VA (r = 0.70 ± 0.18). The APTT-derived SBP demonstrated acceptable accuracy in terms of the mean difference ± standard deviation (−0.01 ± 10.54 mmHg) from the invasive femoral SBP. The area under the receiver operating characteristic (ROC) curve for the ability of the APTT to detect ≥30% decreases in femoral SBP was 0.903 (95% confidential interval, 0.895–0.911). In addition, the APTT performed better than the cPTT and RR interval in the above analysis (all P < 0.05). Therefore, the APTT has acceptable accuracy in tracking beat-to-beat femoral SBP and could detect substantially decreased femoral SBP. These findings indicate that the APTT may be a promising noninvasive surrogate for invasive femoral SBP during VA. A multiparameter model combining APTT and other parameters is needed to further improve the accuracy.

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Acknowledgements

This study was supported in part by the National Natural Science Foundation of China (Nos. 61771465, U1913210), the Shenzhen Science and Technology Projects (No. JCYJ20180703145202065), and the Strategic Priority CAS Project (XDB38040200, XDB38060100). We would like to thank AJE (http://www.aje.com/) for English language editing.

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Author notes

  1. These authors contributed equally: Fen Miao, Bin Zhou, Zengding Liu.

  2. These authors jointly supervised this work: Ye Li, Min Tang.

Authors and Affiliations

  1. Key Laboratory for Health Informatics, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China

    Fen Miao, Zengding Liu, Bo Wen & Ye Li

  2. Department of Cardiology, Laboratory of Heart Center, Zhujiang Hospital, Southern Medical University, Guangzhou, China

    Bin Zhou

  3. Fuwai Hospital, National Center for Cardiovascular Disease, State Key Lab of Cardiovascular Disease, National Clinical Research Center of Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China

    Bin Zhou & Min Tang

  4. Joint Engineering Research Center for Health Big Data Intelligent Analysis Technology, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China

    Ye Li

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Correspondence to Min Tang.

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Miao, F., Zhou, B., Liu, Z. et al. Using noninvasive adjusted pulse transit time for tracking beat-to-beat systolic blood pressure during ventricular arrhythmia. Hypertens Res 45, 424–435 (2022). https://doi.org/10.1038/s41440-021-00795-y

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