Validity and reliability of a novel slow cuff-deflation system for noninvasive blood pressure monitoring in patients with continuous-flow left ventricular assist device

Gregg M. Lanier, Khristine Orlanes, Yacki Hayashi, Jennifer Murphy, Margaret Flannery, Rosie Te-Frey, Nir Uriel, Melana Yuzefpolskaya, Donna M. Mancini, Yoshifumi Naka, Hiroo Takayama, Ulrich P. Jorde, Ryan T. Demmer, Paolo C. Colombo

Research output: Contribution to journalArticle

55 Citations (Scopus)

Abstract

Background-Doppler ultrasound is the clinical gold standard for noninvasive blood pressure (BP) measurement among continuous-flow left ventricular assist device patients. The relationship of Doppler BP to systolic BP (SBP) and mean arterial pressure (MAP) is uncertain and Doppler measurements require a clinic visit. We studied the relationship between Doppler BP and both arterial-line (A-line) SBP and MAP. Validity and reliability of the Terumo Elemano BP Monitor, a novel slow cuff-deflation device that could potentially be used by patients at home, were assessed. Methods and Results-Doppler and Terumo BP measurements were made in triplicate among 60 axial continuousflow left ventricular assist device (HeartMate II) patients (30 inpatients and 30 outpatients) at 2 separate exams (360 possible measurements). A-line measures were also obtained among inpatients. Mean absolute differences (MADs) and correlations were used to determine within-device reliability (comparison of second and third BP measures) and betweendevice validity. Bland-Altman plots assessed BP agreement between A-line, Doppler BP, and Terumo Elemano. Success rates for Doppler and Terumo Elemano were 100% and 91%. Terumo Elemano MAD for repeat SBP and MAP were 4.6±0.6 and 4.2±0.6 mm Hg; repeat Doppler BP MAD was 2.9±0.2 mm Hg. Mean Doppler BP was lower than A-line SBP by 4.1 (MAD=6.4±1.4) mm Hg and higher than MAP by 9.5 (MAD=11.0±1.2) mm Hg; Terumo Elemano underestimated A-line SBP by 0.3 (MAD=5.6±0.9) mm Hg and MAP by 1.7 (MAD=6.0±1.0) mm Hg. Conclusions-Doppler BP more closely approximates SBP than MAP. Terumo Elemano was successful, reliable, and valid when compared with A-line and Doppler.

Original languageEnglish (US)
Pages (from-to)1005-1012
Number of pages8
JournalCirculation: Heart Failure
Volume6
Issue number5
DOIs
StatePublished - Sep 2013
Externally publishedYes

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Heart-Assist Devices
Physiologic Monitoring
Reproducibility of Results
Blood Pressure
Vascular Access Devices
Arterial Pressure
Inpatients
Blood Pressure Monitors
Doppler Ultrasonography
Equipment and Supplies
Ambulatory Care
Outpatients

Keywords

  • Blood pressure measurement/monitoring
  • Heart failure
  • Heart-assist devices
  • Terumo Elemano

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Validity and reliability of a novel slow cuff-deflation system for noninvasive blood pressure monitoring in patients with continuous-flow left ventricular assist device. / Lanier, Gregg M.; Orlanes, Khristine; Hayashi, Yacki; Murphy, Jennifer; Flannery, Margaret; Te-Frey, Rosie; Uriel, Nir; Yuzefpolskaya, Melana; Mancini, Donna M.; Naka, Yoshifumi; Takayama, Hiroo; Jorde, Ulrich P.; Demmer, Ryan T.; Colombo, Paolo C.

In: Circulation: Heart Failure, Vol. 6, No. 5, 09.2013, p. 1005-1012.

Research output: Contribution to journalArticle

Lanier, GM, Orlanes, K, Hayashi, Y, Murphy, J, Flannery, M, Te-Frey, R, Uriel, N, Yuzefpolskaya, M, Mancini, DM, Naka, Y, Takayama, H, Jorde, UP, Demmer, RT & Colombo, PC 2013, 'Validity and reliability of a novel slow cuff-deflation system for noninvasive blood pressure monitoring in patients with continuous-flow left ventricular assist device', Circulation: Heart Failure, vol. 6, no. 5, pp. 1005-1012. https://doi.org/10.1161/CIRCHEARTFAILURE.112.000186
Lanier, Gregg M. ; Orlanes, Khristine ; Hayashi, Yacki ; Murphy, Jennifer ; Flannery, Margaret ; Te-Frey, Rosie ; Uriel, Nir ; Yuzefpolskaya, Melana ; Mancini, Donna M. ; Naka, Yoshifumi ; Takayama, Hiroo ; Jorde, Ulrich P. ; Demmer, Ryan T. ; Colombo, Paolo C. / Validity and reliability of a novel slow cuff-deflation system for noninvasive blood pressure monitoring in patients with continuous-flow left ventricular assist device. In: Circulation: Heart Failure. 2013 ; Vol. 6, No. 5. pp. 1005-1012.
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AU - Hayashi, Yacki

AU - Murphy, Jennifer

AU - Flannery, Margaret

AU - Te-Frey, Rosie

AU - Uriel, Nir

AU - Yuzefpolskaya, Melana

AU - Mancini, Donna M.

AU - Naka, Yoshifumi

AU - Takayama, Hiroo

AU - Jorde, Ulrich P.

AU - Demmer, Ryan T.

AU - Colombo, Paolo C.

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N2 - Background-Doppler ultrasound is the clinical gold standard for noninvasive blood pressure (BP) measurement among continuous-flow left ventricular assist device patients. The relationship of Doppler BP to systolic BP (SBP) and mean arterial pressure (MAP) is uncertain and Doppler measurements require a clinic visit. We studied the relationship between Doppler BP and both arterial-line (A-line) SBP and MAP. Validity and reliability of the Terumo Elemano BP Monitor, a novel slow cuff-deflation device that could potentially be used by patients at home, were assessed. Methods and Results-Doppler and Terumo BP measurements were made in triplicate among 60 axial continuousflow left ventricular assist device (HeartMate II) patients (30 inpatients and 30 outpatients) at 2 separate exams (360 possible measurements). A-line measures were also obtained among inpatients. Mean absolute differences (MADs) and correlations were used to determine within-device reliability (comparison of second and third BP measures) and betweendevice validity. Bland-Altman plots assessed BP agreement between A-line, Doppler BP, and Terumo Elemano. Success rates for Doppler and Terumo Elemano were 100% and 91%. Terumo Elemano MAD for repeat SBP and MAP were 4.6±0.6 and 4.2±0.6 mm Hg; repeat Doppler BP MAD was 2.9±0.2 mm Hg. Mean Doppler BP was lower than A-line SBP by 4.1 (MAD=6.4±1.4) mm Hg and higher than MAP by 9.5 (MAD=11.0±1.2) mm Hg; Terumo Elemano underestimated A-line SBP by 0.3 (MAD=5.6±0.9) mm Hg and MAP by 1.7 (MAD=6.0±1.0) mm Hg. Conclusions-Doppler BP more closely approximates SBP than MAP. Terumo Elemano was successful, reliable, and valid when compared with A-line and Doppler.

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