Evaluation of central hemodynamics using the radial arterial blood pressure waveform in children, adolescents, and young adults

<p>Objectives: The central blood pressure waveform of young children is similar to that of older adults, but differs compared to that in adolescents. This study aimed to examine the accuracy of non-invasive measurements of central hemodynamics in children, adolescents, and young adults. </p><p>Methods and Results: We enrolled 23 patients with cardiac catheterization and a mean age of 10.4 ± 7.2 years (range 1.2-28.2 years, median 7.4 years) in this study. The ascending aortic blood pressure waveform was recorded using a catheter-mounted pressure sensor. Radial artery pulse-waves were recorded simultaneously and noninvasively. We analyzed the relationship between the aortic and radial augmentation indices, and between the ascending aortic systolic and central systolic blood pressure estimated by the radial second systolic pressure method. The radial augmentation index correlated significantly with the aortic augmentation index (r = 0.64, p = 0.0009). The estimated central and aortic systolic blood pressure were significantly correlated (r = 0.87, p < 0.0001). The mean difference between the estimated central systolic and aortic systolic blood pressure was 0.39 ± 7.12 mmHg. In patients with type A aortic blood pressure waveform, the radial second systolic blood pressure correlated significantly with aortic systolic blood pressure; in the case of the type C waveform, the radial first systolic blood pressure correlated strongly with aortic systolic blood pressure. </p><p>Conclusions: Central systolic blood pressure estimation by the radial second systolic pressure method is not reliable in children, adolescents, and young adults. Combining the first and second radial systolic pressure in response to the aortic pressure waveform can accurately estimate central systolic blood pressure. </p>