Clinical Research
Clinical Research Papers
The (dP/dt)max
derived from arterial pulse waveforms during 24 hr blood pressure
oscillometric recording
Giuseppe Germanò, Stefania Angotti,
Miryam Muscolo, Francesco D'Auria and Marcello Giordano
Background The modern developments in engineering allow
one to record the speed at which the blood pressure rises on the
advancing pulse wave front. It was possible to obtain this
through the conversion of a conventional pulse from a single
suprasystolic oscillation to the oscillometric envelope into its
first derivative with respect to time.
Objective The aim of this study was to report a
preliminary comparison between healthy subjects and patients with
heart failure as a first step towards the clinical use of this
first derivative of a time-dependent function (dP/dt).
Methods For 10 normal healthy subjects (aged 37 ± 5 years) and five subjects with ischaemic
cardiomyopathy (aged 41 ± 7 years),
whose ejection fractions (invasively assessed) were <40%, we
evaluated six sequential oscillometric measurements of blood
pressure obtained by using a DynaPulse 5000 (Pulse Metric, San
Diego, California, USA) device, which simultaneously records
blood pressure and analyses every arterial waveform. The mean and
SD of (dP/dt)max for each subject were calculated,
together with the relative mean distribution and the significance
of the differences.
Results The data show that (dP/dt)max of subjects with
an impairment of cardiac function is less than normal. The mean
(dP/dt)max of normal subjects was significantly different (P<
0.05) from that of patients with ischaemic cardiomyopathy and
lower than normal ejection fractions.
Conclusions These preliminary results allowed us to
raise the hypothesis that this parameter, being representative of
the cardiac function, because many data are obtained, is
extremely useful for monitoring changes during daily activities
or to outline the nycthoemeral rhythm. We have to test the
hypotheses that the analyses of the correlations between (dP/dt)max
and other haemodynamic parameters may be used in the
pathophysiological study of cardiomyopathies and that the
comparison of differences in (dP/dt)max can be used in
the evaluation of the effects of the treatment.
Blood Press Monit 3:213-216 © 1998
Lippincott Williams & Wilkins.
Keywords: (dP/dt)max, oscillometry, cardiac
function
*See Blood Pressure Monitoring 1998;
3:213-216
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