中心压力的测量——澳大利亚悉尼麦格里大学Prof. Alberto Avolio专访
动脉压力峰值与心脏压力峰值不同,外周血压并非心脏压力真实值,尤其在运动情况下,仅测外周血压无法对心脏压力负荷准确评估。有必要测定中心血压,测量方法有:利用全部波形的一般传递函数技术;利用部分波形特征,识别第二个收缩期的技术,以及另一种能提供某种波形均值且该均值与收缩压数值相近的技术。此外,一些新的设备和指标也能用于评估中心血压,但仍需进一步观察。
Prof. Alberto Avolio,
生物医学工程教授。
研究领域:
动脉血液动力学、
血压测量、
血管内皮功能等。
The structure of the arterial system is such that when the pulse travels it changes its wave shape. Especially during exercise with higher heart rates, the peak pressures that one measures arterially are actually different than the peak pressures near the heart. So if one wants to assess cardiac function in terms of peak load on the heart, it becomes problematic because the arterial value is not actually the real value.
There are not competing but rather complimentary ways of measuring central pressure. Essentially, there is a technique called the general transfer function which uses the whole waveform. There is another technique that uses a feature of the wave form which is quite good in most cases where one has identifie the second systolic shoulder.If one calibrates that wave form, one can equate that second systolic shoulder to the peak value. In that case you do not get an ascending aortic waveform, but only the values. There are other techniques that look at applying some type of averaging where the wave form is averaged in a certain way and that average turns out to be close to the systolic pressure. Some of the devices coming out now look at central systolic pressure. Outcome studies on these devices are not yet available to indicate whether there is use in knowing this extra number and whether it is better.We’ve seen indications that it seems to have additional value over the conventional measures of systolic pressure. Data are forthcoming to indicate whether being treated to that value is actually better either in efficacy of treatment or avoiding treatment.
动脉压力峰值与心脏压力峰值不同,外周血压并非心脏压力真实值,尤其在运动情况下,仅测外周血压无法对心脏压力负荷准确评估。有必要测定中心血压,测量方法有:利用全部波形的一般传递函数技术;利用部分波形特征,识别第二个收缩期的技术,以及另一种能提供某种波形均值且该均值与收缩压数值相近的技术。此外,一些新的设备和指标也能用于评估中心血压,但仍需进一步观察。