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Validation of oscillometric pulse wave analysis measurements in children
Lee Stoner1, Danielle M Lambrick, Nicole Westrupp
1School of Sport and Exercise, Massey University, Wellington, New Zealand.
Insights
Oscillometric pulse wave analysis (PWA) is a valid tool for measuring central blood pressure and arterial wave reflection in children. This study validates its use in children aged 8-10 years.
Area of Science:
- Cardiovascular physiology
- Pediatric cardiology
- Biomedical engineering
Background:
- Pulse wave analysis (PWA) is a noninvasive method for assessing central blood pressure and arterial wave reflection.
- Tonometry is the gold standard but can be difficult to perform on children.
- Validation of oscillometric PWA in pediatric populations is needed.
Purpose of the Study:
- To validate the use of oscillometric PWA for measuring central blood pressure and arterial wave reflection in children.
- To compare oscillometric PWA with the gold-standard tonometry technique in a pediatric cohort.
Main Methods:
- Fifty-seven healthy children (mean age 9.8 years) participated in the study.
- Central blood pressures and peripheral augmentation index (pAIx) were measured using both oscillometric (Pulsecor R7) and tonometric (SphygmaCor) devices.
- Measurements were taken under standardized conditions between 8-10 am in a fasted state.
Main Results:
- A very strong correlation was observed between the two devices for central systolic (r=0.94), diastolic (r=0.99), and mean (r=0.96) blood pressures.
- Bland-Altman analysis showed a slight bias towards higher systolic blood pressures with the oscillometric monitor (mean difference 4.5 mmHg).
- A good correlation was found for pAIx (r=0.71), with no significant difference between the devices.
Conclusions:
- Oscillometric PWA demonstrates validity for measuring central blood pressure in children aged 8-10 years.
- The technique also provides valid measures of arterial wave reflection (pAIx) in this age group.
- Oscillometric PWA offers a reliable alternative to tonometry for pediatric cardiovascular assessments.
Background:
Pulse wave analysis (PWA) has emerged as a noninvasive, valid, reliable, and widely used technique to investigate central blood pressures and systemic arterial wave reflection (augmentation index). The gold-standard technique is tonometry, but this technique can be challenging, especially when used on children. The purpose of this study was to validate oscillometric PWA for use in children.
Methods:
Fifty-seven healthy children were recruited for participation. Central blood pressures and peripheral augmentation index (pAIx) were measured objectively using oscillometric (Pulsecor R7) and tonometric (SphygmaCor) devices. All measurements were made during the same visit under standardized conditions between the hours of 8 am and 10 am in the fasted state.
Results:
Tonometric measurements were unsuccessful on 1 child. Comparisons were made on 56 children (mean age = 9.8±1.0 y; 57% male). A very strong relationship was found between devices for central systolic (r = 0.94; P < 0.001), diastolic (r = 0.99; P < 0.001) and mean (r = 0.96; P < 0.001) blood pressures. However, Bland-Altman analysis indicated a bias toward greater systolic blood pressures with the oscillometric monitor (mean difference = 4.5mm Hg; 95% confidence interval (CI) = -5.16 to -3.89). A good relationship was found for pAIx (r = 0.71; P < 0.001); the mean difference between devices was -1.70% (95% CI = -4.47% to 1.08%), which is not significantly different from zero.
Conclusions:
Findings from this study suggest that oscillometric PWA provides valid measures of central blood pressure and arterial wave reflection in children aged 8-10 years.
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