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Evaluation of the Vicorder, a novel cuff-based device for the noninvasive estimation of central blood pressure
Giacomo Pucci1, Joseph Cheriyan, Annette Hubsch
1Clinical Pharmacology Unit, University of Cambridge & Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK. giacomo.pucci@gmail.com
Insights
The Vicorder device reliably estimates central blood pressure (cBP) when calibrated to invasive measurements. It offers a simple, noninvasive alternative to tonometry-based methods for assessing cBP.
Area of Science:
- Cardiovascular physiology
- Medical device technology
- Hypertension research
Background:
- Central blood pressure (cBP) is a crucial indicator of cardiovascular risk.
- Accurate cBP measurement is essential for effective hypertension management.
- Existing methods for cBP estimation have limitations.
Purpose of the Study:
- To evaluate the accuracy of the Vicorder, a novel brachial cuff-based device, in estimating central blood pressure (cBP).
- To compare the Vicorder's performance against the SphygmoCor device and invasive measurements.
- To assess the impact of different calibration methods on cBP estimation accuracy.
Main Methods:
- Simultaneous invasive cBP measurements were taken during cardiac angiography in 50 patients.
- The Vicorder and SphygmoCor devices were used to estimate cBP in these patients.
- A separate noninvasive study compared the two devices in 90 healthy individuals using different calibration techniques.
Main Results:
- Both Vicorder and SphygmoCor met accuracy criteria when calibrated to invasive mean arterial pressure (MAP)/diastolic blood pressure (DBP).
- Calibration using oscillometric brachial blood pressure led to underestimation of cSBP by both devices.
- Vicorder demonstrated a good correlation with SphygmoCor in noninvasive settings when calibrated appropriately.
Conclusions:
- The Vicorder provides reliable cSBP estimates when calibrated to invasive pressure, serving as a potential noninvasive alternative to tonometry.
- Calibration method significantly impacts the accuracy of both Vicorder and SphygmoCor.
- Further research may validate Vicorder's clinical utility in diverse populations.
Objectives:
The Vicorder is a new brachial cuff-based device that estimates central blood pressure (cBP) using a brachial-to-aortic transfer function. The aim of this study was to evaluate cBP estimated by the Vicorder.
Methods:
During cardiac angiography, cBP estimated by the Vicorder and the SphygmoCor was evaluated against simultaneous invasive cBP in 50 patients. The two devices were also compared noninvasively in a separate group of 90 healthy individuals.
Results:
Central SBP (cSBP) obtained with each device satisfied the American Association for the Advancement of Medical Instrumentation accuracy criteria when peripheral waveforms were calibrated to invasive mean arterial pressure (MAP)/DBP: estimated - invasive cSBP difference, -4.0 ± 7.4 mmHg, Vicorder, P < 0.001; -1.4 ± 7.9 mmHg, SphygmoCor, P = 0.21. When oscillometric brachial SBP/DBP was used for peripheral waveform calibration, cSBP was underestimated by Vicorder (Δ -6.4 ± 7.4 mmHg, P < 0.001 versus invasive) and more so by SphygmoCor (Δ -11.9 ± 7.2 mmHg, P < 0.001 versus invasive). Conversely, cSBP was more closely estimated by SphygmoCor when waveforms were calibrated to brachial MAP/DBP (Δ -2.8 ± 9.4 mmHg, P = 0.04 versus invasive). In the noninvasive study, Vicorder cSBP correlated well with SphygmoCor cSBP when SphygmoCor waveforms were calibrated to brachial MAP/DBP (121 ± 16 versus 121 ± 17 mmHg, P = 0.2) but not when brachial SBP/DBP was used for calibration (115 ± 19 mmHg, P < 0.001).
Conclusion:
The Vicorder and SphygmoCor devices provide reliable estimates of cSBP when calibrated to invasive pressure. When calibrated to brachial BP, both devices underestimated cSBP, although this was attenuated when SphygmoCor was calibrated to brachial MAP/DBP. Vicorder may be a simple alternative to tonometry-based methods for noninvasive assessment of cBP.
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