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Global versus local linear beat-to-beat analysis of the relationship between arterial pressure and pulse transit time during dynamic exercise

  • A. Porta
  • C. Gasperi
  • G. Nollo
  • D. Lucini
  • P. Pizzinelli
  • R. Antolini
  • M. Pagani
ORIGINAL ARTICLE

Abstract

Global linear analysis has been traditionally performed to verify the relationship between pulse transit time (PTT) and systolic arterial pressure (SAP) at the level of their spontaneous beat-to-beat variabilities: PTT and SAP have been plotted in the plane (PTT,SAP) and a significant linear correlation has been found. However, this relationship is weak and in specific individuals cannot be found. This result prevents the utilization of the SAP–PTT relationship to derive arterial pressure changes from PTT measures on an individual basis. We propose a local linear approach to study the SAP–PTT relationship. This approach is based on the definition of short SAP–PTT sequences characterized by SAP increase (decrease) and PTT decrease (increase) and on their search in the SAP and PTT beat-to-beat series. This local approach was applied to PTT and SAP series derived from 13 healthy humans during incremental supine dynamic exercise (at 10, 20 and 30% of the nominal individual maximum effort) and compared to the global approach. While global approach failed in some subjects, local analysis allowed the extraction of the gain of the SAP–PTT relationship in all subjects both at rest and during exercise. When both local and global analyses were successful, the local SAP–PTT gain is more negative than the global one as a likely result of noise reduction.

Keywords

Pulse transit time Arterial pressure Dynamic exercise Cardiovascular variability 

References

  1. 1.
    Allen RA, Schneider JA, Davidson DM, Winchester MA, Taylor CB (1981) The covariation of blood pressure and pulse transit time in hypertensive patients. Psychophysiology 18:301–306PubMedCrossRefGoogle Scholar
  2. 2.
    Bertinieri G, di Rienzo M, Cavallazzi A, Ferrari AU, Pedotti A, Mancia G (1985) A new approach to analysis of the arterial baroreflex. J Hypertens 3:S79–S81Google Scholar
  3. 3.
    Bland M (2000) An introduction to medical statistics. Oxford University Press, New YorkGoogle Scholar
  4. 4.
    Bramwell J, Hill A (1922) The velocity of the pulse wave in man. Proc R Soc 93:298–306CrossRefGoogle Scholar
  5. 5.
    Davies RJO, Belt PJ, Roberts SJ, Ali NJ, Stradling JR (1993) Arterial blood-pressure responses to graded transient arousal from sleep in normal humans. J Appl Physiol 74:1123–1130PubMedGoogle Scholar
  6. 6.
    Gosling R, Budge M (2003) Terminology for describing the elastic behaviour of arteries. Hypertension 41:1180–1182CrossRefPubMedGoogle Scholar
  7. 7.
    Gribbin B, Steptoe A, Sleight P (1976) Pulse wave velocity as a measure of blood pressure change. Psychophysiology 13:86–90PubMedCrossRefGoogle Scholar
  8. 8.
    Laude D, Elghozi JL, Girard A, Bellard F, Bouhaddi M, Castiglioni P, Cerutti C, Cividjian A, di Rienzo M, Fortrat JO, Janssen B, Karemaker JM, Leftheriotis G, Parati G, Persson PB, Porta A, Quintin L, Regnard J, Rudiger H, Stauss HM (2004) Comparison of various techniques used to estimate spontaneous baroreflex sensitivity (the EuroBaVar study). Am J Physiol 286:R226–R231Google Scholar
  9. 9.
    Lucini D, Dalla Vecchia L, Porta A, Malliani A, Pagani M (1997) Non-invasive assessment of the changes in static and oscillatory components of peripheral pressure/flow relationships produced by moderate exercise in humans. J Hypertens 15:1755–1760CrossRefPubMedGoogle Scholar
  10. 10.
    Marie G, Lo C, van Jones J, Johnston D (1984) The relationship between arterial blood pressure and pulse transit time during dynamic and static exercise. Psychophysiology 21:521–527CrossRefGoogle Scholar
  11. 11.
    Palus M (1996) Detecting nonlinearity in multivariate time series. Phys Lett A 213:138–147CrossRefMathSciNetzbMATHGoogle Scholar
  12. 12.
    Payne RA, Symeonides CN, Webb DJ, Maxwell SRJ (2006) Pulse transit time measured from the ECG: an unreliable marker of beat-to-beat blood pressure. J Appl Physiol 100:136–141CrossRefPubMedGoogle Scholar
  13. 13.
    Porta A, Gasperi C, Nollo G, Lucini D, Antolini R, Pagani M (2005) Sequence analysis of pulse transit time and systolic blood pressure during dynamic exercise. In: Computers in cardiology 2005, Lyon, France, 25–28 September 2005Google Scholar
  14. 14.
    Smith RP, Argod J, Pepin J-L, Levy PA (1999) Pulse transit time: an appraisal of potential clinical applications. Thorax 54:452–458PubMedCrossRefGoogle Scholar
  15. 15.
    Steptoe A, Smulyan H, Gribbin B (1976) Pulse wave velocity and blood pressure change: calibration and applications. Psychophysiology 15:488–493CrossRefGoogle Scholar
  16. 16.
    Theiler J, Eubank S, Longtin A, Galdrikian J (1992) Testing for nonlinearity in time series: the method of surrogate data. Physica D 58:77–94CrossRefGoogle Scholar
  17. 17.
    Wippermann CF, Schranz D, Huth RG (1995) Evaluation of the pulse wave pressure arrival time as a marker for blood pressure changes in critically ill infants and children. J Clin Monit 11:316–321CrossRefGoogle Scholar

Copyright information

© International Federation for Medical and Biological Engineering 2006

Authors and Affiliations

  • A. Porta
    • 1
  • C. Gasperi
    • 2
  • G. Nollo
    • 2
  • D. Lucini
    • 3
  • P. Pizzinelli
    • 3
  • R. Antolini
    • 2
  • M. Pagani
    • 3
  1. 1.Dipartimento di Scienze Precliniche, LITA di Vialba, Laboratorio di Modellistica di Sistemi ComplessiUniversita’ degli Studi di MilanoMilanoItaly
  2. 2.Dipartimento di FisicaUniversita’ di TrentoTrentoItaly
  3. 3.Dipartimento di Scienze Cliniche, Unita’ di Medicina TelematicaUniversita’ degli Studi di MilanoMilanItaly

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