Table 3:  Methods used in clinical trials and animal studies.

Method

Advantages

Limitations

Clinical use/ future possibilities

Carotid pressure measurement

-   better prediction of cardiovascular events than peripheral BP values;

-   highly observer dependent;

-   peripheral interferences;

-   imprecise;

-   noninvasive central BP measurement;

Brachial waveform

-   better prediction of cardiovascular events than peripheral BP values;

-   generalized transfer function is needed;

-   identification of the late systolic shoulder of the peripheral pressure waveform;

-   proprietary algorithm to obtain central BP due to factors moulding pulse wave shape remote to aorta;

-   noninvasive central BP measurement;

Radial waveform

-   easier to obtain than brachial waveform;

-   better prediction of cardiovascular events than peripheral BP values;

-   brachial to radial amplification;

-   should not be calibrated to brachial BP;

-   noninvasive central BP measurement;

Photoplethysmography

-   allows to measure BP on ear lope, finger or toe;

-   additional information regarding oxygen saturation and cardiac output;

-   may be imprecise;

-   outcomes may be influenced by temperature and sympathetic activity;

-   noninvasive, continuous BP measurements;

-   especially in neonates and children;

Volume clamping

-   noninvasive method;

-   good reproducibility;

-   information regarding beat-to-beat BP changes;

-   differences in SBP may reach statistical significance;

-   arterial pressure is calculated indirectly;

-   noninvasive, continuous BP measurement;

Pulse Transit Time

-   short-term changes in BP may be detected;

-   continuous measurement is possible;

-   affected by arterial stiffness, autoregulation and wave reflection in peripheral arteries;

-   continuous noninvasive BP measurements;

Doppler assessment of SBP

(including laser Doppler)

-   very sensitive method;

-   useful in low BP values;

-   good reproducibility;

-   high costs;

-   a lot of equipment is needed;

-   critical ischemia, when BP is not detectable by other methods;

Electrical Impedance Tomography

-   analyzes pulse in the aorta;

-   free of peripheral interferences;

-   complicated reconstruction algorithms;

-   lack of sufficient data regarding usage;

-   new method;

-   introduced to animal studies;

High Definition Oscillometry

-   allows measurements of AP in heart frequencies up to 500 bpm;

-   allows to accomplish direct SBP and DBP;

-   linearity during deflation;

-   real time control;

- long term recordings are unavailable;

- we found no human studies;

-   studies regarding pharmacology in animals;

Radiofrequency Ultrasound Wall Tracking of the carotid artery

-   well correlated with directly measured SBP;

-   gives information about central BP;

-   noninvasive;

-   more adequate in children;

-   needs to be calibrated to mean and DBP measured i.e. with sphygmomanometer on brachial artery;

-   amplification between brachial and carotid artery;

-   noninvasive control of central BP, i.e. in ICU stations;

-   noninvasive control of central BP in children;

Telemonitoring system

-   improves treatment goal’s achievement;

-   allows better patient monitoring;

-   low availability;

-   high costs;

-   monitoring of patients, especially older, with multiple comorbidities;

 

AP:  Arterial pressure; BP: Blood pressure; DBP:  Diastolic blood pressure; ICU: Intensive care unit; SBP: Systolic blood pressure