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British Journal of Anaesthesia, 2002, Vol. 88, No. 4 481-488
© 2002 The Board of Management and Trustees of the British Journal of Anaesthesia

Clinical Investigations

Can a clinically useful aortic pressure wave be derived from a radial pressure wave?{dagger}

S. Söderström*,1, G. Nyberg2 , M. F. O’Rourke3, J. Sellgren1 and J. Pontén1

1Department of Anaesthesia and Intensive Care, 2 Department of Clinical Physiology, Sahlgrenska University Hospital, S-413 45 Göteborg, Sweden. 3Department of Cardiology, St Vincent’s Hospital, University of New South Wales, Darlinghurst NSW 2010, Australia*Corresponding author

{dagger}Declaration of interest. Professor M. F. O’Rourke is a Director of PWV Medical, Sydney. PWV Medical provided funds and facilities for analysis of the data, and markets apparatus that uses the methods used in this study.

Background. The information contained in arterial pressure waveforms is probably underused by most clinicians who manage critically ill patients. It is not generally known that an aortic pressure wave can be synthesized by applying a generalized transfer function to the radial arterial pressure wave. We validated a commercially available system, SphygmoCorTM (PWV Medical, Sydney).

Methods. Ascending aortic pressure waves were synthesized and comparisons were made between the synthesized aortic waveforms, the measured aortic and radial arterial waveforms. Ascending aortic pressure waves (catheter-tip manometer) and radial artery pressure waves (short fluid-filled catheter) were recorded simultaneously in 12 patients with angina pectoris (age 62–76 years) undergoing cardiac catheterization. Patients were studied at rest, following midazolam, sublingual nitroglycerin and during Valsalva manoeuvres.

Results. Both midazolam and nitroglycerin lowered mean arterial pressure but nitroglycerin caused a more selective decrease in the measured and synthesized aortic systolic pressures than in the radial artery pressure. The synthesized aortic systolic pressure was less, by 6–8 mm Hg (SD 2–3) and the synthesized aortic diastolic pressure greater, by 4 mm Hg (SD 2). Despite these differences in pulse pressure, the synthesized waveform tracked the measured waveform before and during interventions.

Conclusions. By deriving an aortic waveform from the radial pulse, monitoring of left ventricular afterload can improve without more invasive means.

Br J Anaesth 2002; 88: 481–8


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