Invasive validation of a new oscillometric device (Arteriograph) for measuring augmentation index, central blood pressure and aortic pulse wave velocity
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Published on: May 3, 2018
Iván G Horváth1, Adám Németh, Zsófia Lenkey
1aHeart Institute, Medical School, University of Pécs, Pécs, Hungary bDepartment of Cardiology, University of Rome La Sapienza, Polo Pontino, Italy.
Insights
A new oscillometric device accurately measures aortic pulse wave velocity (PWVao), aortic augmentation index (Aix), and central systolic blood pressure (SBPao) noninvasively. These findings support its clinical use for assessing cardiovascular health.
Area of Science:
- Cardiovascular Physiology
- Biomedical Engineering
- Diagnostic Technology
Background:
- Accurate measurement of aortic pulse wave velocity (PWVao), aortic augmentation index (Aix), and central systolic blood pressure (SBPao) is clinically significant.
- Current methods for obtaining these aortic parameters are often invasive and difficult to access.
Purpose of the Study:
- To evaluate the accuracy of a new, easily applicable oscillometric device, the Arteriograph.
- To compare simultaneous noninvasive measurements from the Arteriograph against invasive reference standards.
Main Methods:
- Invasive measurements of aortic Aix, SBPao, and PWVao were performed during cardiac catheterization.
- These invasive values were compared with simultaneous measurements obtained using the Arteriograph device.
Main Results:
- Strong correlations (r=0.9-0.95, P<0.001) were observed between invasive and Arteriograph-derived Aix and SBPao.
- PWVao measurements showed excellent agreement (Pearson's r=0.91, P<0.001) between invasive and oscillometric methods.
- Limits of agreement were acceptably low (11.4% for Aix, 1.59 m/s for PWVao) for clinical application.
Conclusions:
- The Arteriograph device accurately measures aortic Aix, SBPao, and PWVao noninvasively.
- The device demonstrates strong correlation and low limits of agreement compared to invasive methods.
- These findings support the clinical utility of the Arteriograph for assessing central hemodynamic parameters.
Background:
The importance of measuring aortic pulse wave velocity (PWVao), aortic augmentation index (Aix) and central systolic blood pressure (SBPao) has been shown under different clinical conditions; however, information on these parameters is hard to obtain. The aim of this study was to evaluate the accuracy of a new, easily applicable oscillometric device (Arteriograph), determining these parameters simultaneously, against invasive measurements.
Methods:
Aortic Aix, SBPao and PWVao were measured invasively during cardiac catheterization in 16, 55 and 22 cases, respectively, and compared with the values measured by the Arteriograph.
Results:
We found strong correlation between the invasively measured aortic Aix and the oscillometrically measured brachial Aix on either beat-to-beat or mean value per patient basis (r = 0.9, P < 0.001; r = 0.94, P < 0.001), which allowed the noninvasive calculation of the aortic Aix without using generalized transfer function. Similarly strong correlation (r = 0.95, P < 0.001) was found between the invasively measured and the noninvasively calculated central SBPao; furthermore, the BHS assessment of the paired differences fulfilled the 'B' grading. The PWVao values measured invasively and by Arteriograph were 9.41 ± 1.8 m/s and 9.46 ± 1.8 m/s, respectively (mean ± SD); furthermore, the Pearson's correlation was 0.91 (P < 0.001). The limits of agreement were 11.4% for aortic Aix and 1.59 m/s for PWVao.
Conclusion:
Aix, SBPao and PWVao, measured oscillometrically, showed strong correlation with the invasively obtained values. The observed limits of agreement are encouragingly low for accepting the method for clinical use. Our results suggest that the PWVao values, measured by Arteriograph, are close to the true aortic PWV, determined invasively.
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