Inter-Day Reliability of Finapres^® Cardiovascular Measurements During Rest and Exercise

Abstract

This study evaluated the inter-day test-retest reliability of the Finapres^® finger pulse pressure measuring device during rest and exercise. Eight male participants visited the laboratory twice for evaluation of the inter-day reliability of the Finapres^® finger-pulse pressure device to measure: heart rate (HR), stroke volume (SV), cardiac output (Q̇) and mean arterial pressure (MAP) at rest, and treadmill walking at 3 km/h on 1% and 5% inclines. There were no systematic biases for any of the variables between days. The coefficient of variation (CV%) and 95% limits of agreement (95% LoA) was smallest for MAP (CV%=1.6–3.2%; LoA total error=4.6–12 mmHg) and HR (CV%=3.2–3.9%; LoA total error=6.8–11.9 b/min), increasing with exercise intensity (gradient). The pattern of error was different for Q̇, with decreasing CV% (4.8–3.8%) and LoA (4.2–5.7 L/min) from rest to 5% gradient, with the larger errors occurring for resting SV (CV=7.4%; LoA total error=21.5 ml). The device measures MAP and HR reliably between days; however, error increases at higher intensities. The measurement of SV is less reliable, probably owing to underlying algorithmic assumptions.

Key words

Measurement error - blood pressure - cardiac

• References

• 1 Atkinson G, Nevill AM. Statistical methods for assessing measurement error (reliability) in variables relevant to sports medicine. Sports Med 1998; 26: 217-238
• 2 Batterham A, Atkinson G. How big does my sample need to be? A primer on the murky world of sample size estimation. Phys Ther Sport 2005; 6: 153-163
• 3 Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1986; i: 307-310
• 4 Bogert LW, Van Lieshout JJ. Non-invasive pulsatile arterial pressure and stroke volume changes from the human finger. Exp Physiol 2005; 90: 437-446
• 5 Bos WJW, Imholz BPM, van Goudoever J, Wesseling KH, van Montfrans GA. The reliability of noninvasive continuous finger blood pressure measurement in patients with both hypertension and vascular disease. Am J Hypertens 1992; 5: 529-535
• 6 Gault ML, Clements RE, Willems MET. Cardiovascular responses during downhill treadmill walking at self-selected intensity in older adults. J Aging Phys Act 2013; 21: 335-347
• 7 Harriss DJ, Atkinson G. Ethical standards in sports and exercise science research: 2016 update. Int J Sports Med 2015; 36: 1121-1124
• 8 Hodges GJ, Sharp L, Clements RE, Goldspink DF, George KP, Cable NT. Influence of age, sex, and aerobic capacity on forearm and skin blood flow and vascular conductance. Eur J Appl Physiol 2010; 109: 1009-1015
• 9 Imholz BPM, Wieling W, van Montfrans GA, Wesseling KH. Fifteen years experience with finger arterial pressure monitoring: assessment of the technology. Cardiovasc Res 1998; 38: 605-616
• 10 Imholz BPM, Wieling W, Langewouters GJ, van Montfrans GA. Continuous finger arterial pressure utility in the cardiovascular laboratory. Clin Autonomic Res 1991; 1: 45-53
• 11 Imholz BPM, Parati G, Mancia G, Wesseling KH. Effects of graded vasoconstriction upon the measurement of finger arterial pressure. J Hypertens 1992; 10: 979-984
• 12 Imholz BPM, van Montfrans GA, Settels JJ, van der Hoeven GMA, Karemaker JM, Wieling W. Continuous noninvasive blood pressure monitoring: Reliability of Finapres device during the Valsalva manoeuvre. Cardiovasc Res 1988; 22: 390-397
• 13 Kaufman MP, Hayes SG. The exercise pressor reflex. Clin Auton Res 2002; 12: 429-439
• 14 Langewouters GJ, Wesseling KH, Goedhard WJA. The static elastic properties of 45 human thoracic and 20 abdominal aortas in vitro and the parameters of a new model. J Biomech 1984; 17: 425-535
• 15 Lin HF, Dhindsa MS, Tarumi T, Miles SC, Umpierre D, Tanaka H. Impact of blood pressure cuff inflation rates on flow-mediated dilatation and contralateral arm response. J Hum Hypertens 2012; 26: 35-40
• 16 Marcora SM, Staiano W, Manning V. Mental fatigue impairs physical performance in humans. J Appl Physiol 2009; 106: 857-864
• 17 Paneraia RB, Sammonsb EL, Smitha SM, Rathbonea WE, Bentleyc S, Potterd JF, Samania NJ. Transient drifts between Finapres and continuous intra-aortic measurements of blood pressure. Blood Press Monit 2007; 12: 369-376
• 18 Remmen JJ, Aengevaeren WRM, Verheugt FWA, Van Der Werf T, Luijten HE, Bos A. Jansen RWMM. Finapres arterial pulse wave analysis with Modelflow is not a reliable non-invasive method for assessment of cardiac output. Clin Sci 2002; 103: 143-149
• 19 Ristuccia HL, Grossman P, Watkins LL, Lown B. Incremental bias in Finapres estimation of baseline blood pressure levels over time. Hypertension 1997; 29: 1039-1043
• 20 Stokes DN, Clutton-Brock T, Patil C, Thompson JM, Hutton P. Comparison of invasive and non-invasive measurement of continuous arterial pressure using the Finapres. Brit J Anaesth 1991; 67: 26-35
• 21 Taylor CA, Hughes TJR, Zarins CK. Effect of exercise on hemodynamic conditions in the abdominal aorta. J Vasc Surg 1999; 29: 1077-1089
• 22 Truijen J, van Lieshout JJ, Wesselink WA, Westerhof BE. Noninvasive continuous hemodynamic monitoring. J Clin Monit Comput 2012; 26: 267-278
• 23 Van Lieshout JJ, Toska K, Van Lieshout EJ, Eriksen M, Walloe L, Wesseling KH. Beat-to-beat noninvasive stroke volume from arterial pressure and Doppler ultrasound. Eur J Appl Physiol. 2003; 90: 131-137
• 24 Wecht JM, Weir JP, Bauman WA. Inter-day reliability of blood pressure and cerebral blood flow velocities in persons with spinal cord injury and intact controls. J Spinal Cord Med 2017; 40: 159-169
• 25 Wesseling KH. A century of noninvasive arterial pressure measurement: from Marey to Penaz and Finapres. Homeostasis 1995; 36: 2-3
• 26 Wesseling KH, Jansen JRC, Settels JJ, Schreuder JJ. Computation of aortic flow from pressure in humans using a nonlinear, three-element model. J Appl Physiol 1993; 74: 2566-2573
• 27 Wesseling KH, Smith NT, Nichols WW, Weber H, De Wit B, Beneken JEW. Beat-to-beat cardiac output from the arterial pressure pulse contour. In: Feldman SA, Leigh JM, Spierdijk J. (eds.). Measurement Anaesthesia. Leiden: Leiden University Press; 1974: 148-164
• 28 White WB, Berson WB, Robbins C, Jamieson MJ, Prisant LM, Roccella E, Sheps SG. National standard for measurement of resting and ambulatory blood pressures with automated sphygmomanometers. Hypertension 1993; 21: 504-509