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Updated: May 3, 2026
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Published on: May 3, 2018
Repeatability of SphygmoCor pulse wave analysis in assessing arterial wave reflection in pregnancy using applanation
Michael A Crilly1, Kirsty M Orme, Joan Henderson
1Institute of Applied Health Sciences, Aberdeen University Medical School , Aberdeen , UK .
Objective:
To estimate clinical agreement in relation to measuring aortic augmentation index (AIX-75) in pregnancy in a routine clinical setting.
Methods:
A hospital-based clinical agreement study of 20 women in which two trained nurses alternated in measuring arterial function (AIX standardized to a heart rate of 75 beats-per-minute, AIX-75) on a single occasion in triplicate, after participants had rested semi-recumbent for 15 min. Right brachial blood pressure (BP) was measured using the Microlife 3BTO-A oscillometric device. Radial applanation pulse wave analysis (PWA) was undertaken according to current guidelines using the SphygmoCor device with a hand-held Millar tonometer applanated at the right radial artery. Each nurse was blinded to others PWA results. Observer agreement was assessed using the Bland-Altman "limits of agreement" (LOA, mean difference ±2 SD) approach.
Results:
Median gestation was 37 weeks (range: 12-42), mean age 31 years, 30% nulliparous, mean brachial BP 128/79 mm Hg. Based on all six PWA measurements, mean AIX-75 was 11.7 (range: -18 to +35). The between-observer LOA was 0.1 ± 11.0 and the within-observer LOA's were 1 ± 10 and -2 ± 8 for the two nurses. Observer differences did not vary systematically with the magnitude of AIX-75.
Conclusion:
AIX-75 can be measured by nurses using PWA in pregnancy with a high level of observer agreement.
Related Concept Videos
01:23Assessment of blood pressure in brachial artery(two-step method)
01:28Special considerations while measuring blood pressure
Monitoring Both Arms:
Monitoring BP in both arms during the initial assessment is advisable, as the systolic value may differ by five to ten mm Hg between arms. For subsequent BP assessments, use the arm with the higher reading.
01:19Assessing Blood pressure using a doppler ultrasound
Pre-Procedural Guidelines for Doppler Ultrasound Blood Pressure Assessment:
Preparation of Equipment:
01:21Sites for measuring blood pressure
The Brachial Artery: Primary Site for Blood Pressure Measurement
01:15Assessment of blood pressure in brachial artery(one-step method)
Prepare for the Procedure:
01:25Assessment of apical radial pulse
The A-R pulse assessment involves simultaneous evaluation of the apical and radial pulses. When the apical and radial pulse rates vary, this assessment helps identify a pulse deficit.
Pre-Procedural Preparation