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Updated: May 7, 2026
Measuring the Carotid to Femoral Pulse Wave Velocity (Cf-PWV) to Evaluate Arterial Stiffness
Published on: May 3, 2018
Carotid-femoral pulse wave velocity assessment using novel cuff-based techniques: comparison with tonometric
Mark Butlin1, Ahmad Qasem, Francesca Battista
1aThe Australian School of Advanced Medicine, Macquarie University, Sydney, New South Wales, Australia bUniversitá degli Studi di Perugia and Struttura Complessa di Medicina Interna, Ospedale 'S. Maria', Terni, Italy cUniversité Paris Descartes, INSERM, UMR970, Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Départent of Pharmacologie, Paris, France dClinical Pharmacology Unit, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK.
Insights
A novel algorithm validates cuff-based carotid-femoral pulse wave velocity (cf-PWV) measurement. This method, adjusted for the femoral segment, provides results comparable to the gold standard tonometric approach, improving cardiovascular risk assessment.
Area of Science:
- Cardiovascular Physiology
- Biomedical Engineering
- Diagnostic Methods
Background:
- Carotid-femoral pulse wave velocity (cf-PWV) predicts cardiovascular outcomes.
- Conventional tonometric measurement is time-consuming and requires electrocardiogram gating.
- Leg cuff detection offers a faster alternative but yields different cf-PWV values.
Purpose of the Study:
- To validate a novel algorithm for cuff-based cf-PWV measurement.
- To compare cuff-based cf-PWV with the established tonometric method.
- To assess the algorithm's ability to correct for the additional femoral segment transit time.
Main Methods:
- Eighty-eight participants were recruited across four centers.
- Carotid-femoral pulse wave velocity was measured using both tonometer and thigh cuff devices.
- A novel algorithm was applied to the cuff-based measurements, with comparisons made using Bland-Altman and regression analysis.
Main Results:
- Unadjusted cuff-based cf-PWV was lower than tonometric measurements (6.11 vs. 7.02 m/s).
- After applying the algorithm, cuff-based cf-PWV (7.04 m/s) became comparable to tonometric measurements (P=0.86).
- The adjusted cuff-based method showed no age dependence, unlike the unadjusted method.
Conclusions:
- A cuff-based cf-PWV assessment is validated against the tonometric method.
- The novel algorithm effectively corrects for the additional femoral segment, yielding comparable results.
- This adjusted cuff-based method offers a viable alternative for cf-PWV measurement, aligning with existing population data.
Background:
Carotid-femoral pulse wave velocity, a predictor of cardiovascular outcome, is conventionally measured using a tonometer sequentially placed upon the carotid and femoral arteries, gated using an electrocardiogram. Leg cuff detection of the femoral pulse removes the need for signal gating, reduces the time required for a single measurement, but gives different pulse wave velocity values to tonometric analysis. A novel algorithm to correct for the transit time and distance related to the additional femoral segment was applied to the cuff-based approach in this study.
Method:
Eighty-eight individuals were recruited across four centres and carotid-femoral pulse wave velocity measured in triplicate using two operators with both a tonometer-based device and a device using an inflated thigh cuff with and without the use of the novel algorithm. Comparison was made by Bland-Altman and regression analysis.
Results:
The unadjusted cuff-based approach gave lower pulse wave velocity values than the tonometer-based approach (6.11 ± 1.27 and 7.02 ± 1.88 m/s, P < 0.001). With application of the algorithm, the cuff-based device gave similar pulse wave velocity values (7.04 ± 1.72 m/s) as the tonometer-based approach (P = 0.86). Analysis of covariance with age showed a difference between the tonometer and cuff-based methods (P < 0.001), with a dependence upon age (P = 0.004). The adjusted cuff-based method gave similar results to the tonometer-based method (P = 0.94), with no dependence upon age (P = 0.46).
Conclusion:
This study provided validation of a cuff-based assessment of carotid-femoral pulse wave velocity against the universally accepted tonometric method. Adjusting the cuff-based method for the additional femoral segment measured gives results comparable to the tonometer-based method, for which the majority of population data exist to date.
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