Arterial blood pressure monitoring in stroke cohorts: the impact of reduced sampling rates to optimise remote patient monitoring.

IF 1.2 4区医学 Q4 PERIPHERAL VASCULAR DISEASE Blood Pressure Monitoring Pub Date : 2024-12-01 Epub Date: 2024-08-12 DOI:10.1097/MBP.0000000000000721

James D Ball, Ronney B Panerai, Tim Henstock, Jatinder S Minhas

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Abstract

Objective: Remote patient monitoring (RPM) beat-to-beat blood pressure (BP) provides an opportunity to measure poststroke BP variability (BPV), which is associated with clinical stroke outcomes. BP sampling interval (SI) influences ambulatory BPV, but RPM BP SI optimisation research is limited. SI and RPM device capabilities require compromises, meaning SI impact requires investigation. Therefore, this study assessed healthy and stroke subtype BPV via optimised BP sampling, aiding sudden BP change identification and potentially assisting cardiovascular event (recurrent stroke) prediction.

Methods: Leicester Cerebral Haemodynamic Database ischaemic [acute ischaemic stroke (AIS), n = 68] and haemorrhagic stroke (intracerebral haemorrhage, n = 12) patient and healthy control (HC, n = 40) baseline BP data were analysed. Intrasubject and interpatient SD (SD i /SD p ) represented individual/population variability with synthetically altered SIs. Matched-filter approaches using cross-correlation function detected sudden BP changes.

Results: At SIs between 1 and 180 s, SBP and DBP SD i staticised while SD p increased at SI < 30 s. Mean BP and HR SD i and SD p increased at SI < 60s. AIS BPV, normalised to SI1s, increased at SI30s (26%-131%) and SI120s (1%-274%). BPV increased concomitantly with SI. Cross-correlation analysis showed HC and AIS BP sudden change detection accuracy reductions with increasing SI. Positive BP deviation detection fell 48.48% (SI10s) to 78.79% (SI75s) in HC and 67.5% (SI10s) to 100% (SI75s) in AIS. Negative BP deviation detection fell 50% (SI10s) to 82.35% (SI75s) in HC and 52.27% (SI10s) to 95.45% (SI75s) in AIS.

Conclusion: Sudden BP change detection and BPV are relatively robust to SI increases within certain limits, but accuracy reductions generate unacceptable estimates, considerable within RPM device design. This research warrants further SI optimisation.

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中风队列中的动脉血压监测：降低采样率对优化远程患者监测的影响。

目的：远程患者监测（RPM）逐搏血压（BP）为测量卒中后血压变异性（BPV）提供了机会，而血压变异性与临床卒中预后有关。血压采样间隔（SI）会影响非卧床血压变异性，但 RPM 血压采样间隔优化研究却很有限。SI 和 RPM 设备的功能需要折衷，这意味着 SI 的影响需要调查。因此，本研究通过优化血压采样评估健康和中风亚型的血压值，帮助识别血压突变，并有可能帮助预测心血管事件（复发性中风）：分析了莱斯特脑血流动力学数据库缺血性[急性缺血性卒中（AIS），n = 68]和出血性卒中（脑内出血，n = 12）患者和健康对照（HC，n = 40）的基线血压数据。受试者内和患者间 SD（SD i /SD p）代表个体/群体的变异性，SI 被合成改变。使用交叉相关函数的匹配过滤方法检测血压突变：结果：在 1 至 180 秒的 SI 中，SBP 和 DBP SD i 保持不变，而 SD p 在 SI 中增加：血压骤变检测和 BPV 在一定范围内对 SI 的增加具有相对的鲁棒性，但精度的降低会产生不可接受的估计值，这在 RPM 设备设计中相当可观。这项研究值得进一步优化 SI。

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来源期刊

Blood Pressure Monitoring 医学-外周血管病

CiteScore

2.00

自引率

7.70%

发文量

110

审稿时长

>12 weeks

期刊介绍： Blood Pressure Monitoring is devoted to original research in blood pressure measurement and blood pressure variability. It includes device technology, analytical methodology of blood pressure over time and its variability, clinical trials - including, but not limited to, pharmacology - involving blood pressure monitoring, blood pressure reactivity, patient evaluation, and outcomes and effectiveness research. This innovative journal contains papers dealing with all aspects of manual, automated, and ambulatory monitoring. Basic and clinical science papers are considered although the emphasis is on clinical medicine. Submitted articles undergo a preliminary review by the editor. Some articles may be returned to authors without further consideration. Those being considered for publication will undergo further assessment and peer-review by the editors and those invited to do so from a reviewer pool.