Influence of timing algorithm on brachialankle pulse wave velocity measurement

The baPWV measurement is a non-invasive and convenient technique in an assessment of arterial stiffness. Despite its widespread application, the influence of different timing algorithms is still unclear. The present study was conducted to investigate the influence of six timing algorithms (MIN, MAX, D1, D2, MDP and INS) on the baPWV measurement and to evaluate the performance of them. Forty-five CAD patients and fifty-five healthy subjects were recruited in this study. A PVR acquisition apparatus was built up for baPWV measurement. The baPWV and other related parameters were calculated separately by the six timing algorithms. The influence and performance of the six algorithms was analyzed. The six timing algorithms generate significantly different baPWV values (left: F=29.036, P<0.001; right: F=40.076, P<0.001). In terms of reproducibility, the MAX has significantly higher CV value (≥ 18.6%) than the other methods, while the INS has the lowest CV value (≤ 2.7%). On the performance of classification, the INS produces the highest AUC values (left: 0.854; right: 0.872). The MIN and D2 also have a passable performance (AUC > 0.8). The choice of timing algorithm affects baPWV values and the quality of measurement. The INS method is recommended for baPWV measurement.