Related Experiment Video
Updated: Apr 22, 2026
Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
Evaluation of a novel brachial cuff-based oscillometric method for estimating central systolic pressure in
Pantelis A Sarafidis1, Panagiotis I Georgianos, Antonios Karpetas
1Department of Nephrology, Hippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Insights
The Mobil-O-Graph device shows good agreement for aortic blood pressure and augmentation index in hemodialysis patients, but slightly underestimates pulse wave velocity compared to the Sphygmocor device.
Area of Science:
- Cardiovascular Physiology
- Nephrology
- Medical Devices
Background:
- Elevated wave reflections, arterial stiffness, and ambulatory blood pressure (BP) are key cardiovascular risk factors in end-stage renal disease (ESRD).
- Accurate measurement of these parameters is crucial for risk stratification in ESRD patients undergoing hemodialysis.
- The Mobil-O-Graph is a novel oscillometric device for assessing aortic BP, augmentation index (AIx), and pulse wave velocity (PWV).
Purpose of the Study:
- To validate the Mobil-O-Graph device against a gold-standard tonometric device (Sphygmocor) in hemodialysis patients.
- To assess the agreement and correlation of aortic BP, AIx, and PWV measurements between the two devices.
Main Methods:
- Seventy-three hemodialysis patients participated in the study.
- Measurements of aortic SBP (aSBP), heart rate-adjusted AIx (AIx(75)), and PWV were taken using both Mobil-O-Graph and Sphygmocor devices in a randomized order.
- Sphygmocor calibration utilized brachial BP measured by a mercury sphygmomanometer.
Main Results:
- No significant differences were found between Mobil-O-Graph and Sphygmocor for aSBP (p=0.068) and AIx(75) (p=0.229).
- A slight underestimation of PWV was observed with Mobil-O-Graph compared to Sphygmocor (p<0.01).
- High correlations were found for all parameters: aSBP (r=0.770), AIx(75) (r=0.400), and PWV (r=0.739). Bland-Altman analysis indicated acceptable agreement for aSBP and AIx(75), with no systemic bias for PWV.
Conclusions:
- The Mobil-O-Graph demonstrates acceptable agreement for measuring aSBP and AIx(75) in hemodialysis patients, similar to other populations.
- While PWV is slightly underestimated by the Mobil-O-Graph, the device shows potential for assessing arterial hemodynamics in this patient group.
Background/Aims:
Elevated wave reflections and arterial stiffness, as well as ambulatory blood pressure (BP) are independent predictors of cardiovascular risk in end-stage-renal-disease. This study is the first to evaluate in hemodialysis patients the validity of a new ambulatory oscillometric device (Mobil-O-Graph, IEM, Germany), which estimates aortic BP, augmentation index (AIx) and pulse wave velocity (PWV).
Methods:
Aortic SBP (aSBP), heart rate-adjusted AIx (AIx(75)) and PWV measured with Mobil-O-Graph were compared with the values from the most widely used tonometric device (Sphygmocor, ArtCor, Australia) in 73 hemodialysis patients. Measurements were made in a randomized order after 10 min of rest in the supine position at least 30 min before a dialysis session. Brachial BP (mercury sphygmomanometer) was used for the calibration of Sphygmocor's waveform.
Results:
Sphygmocor-derived aSBP and AIx(75) did not differ from the relevant Mobil-O-Graph measurements (aSBP: 136.3 ± 19.6 vs. 133.5 ± 19.3 mm Hg, p = 0.068; AIx(75): 28.4 ± 9.3 vs. 30.0 ± 11.8%, p = 0.229). The small difference in aSBP is perhaps explained by a relevant difference in brachial SBP used for calibration (146.9 ± 20.4 vs. 145.2 ± 19.9 mm Hg, p = 0.341). Sphygmocor PWV was higher than Mobil-O-Graph PWV (10.3 ± 3.4 vs. 9.5 ± 2.1 m/s, p < 0.01). All 3 parameters estimated by Mobil-O-Graph showed highly significant (p < 0.001) correlations with the relevant measurements of Sphygmocor (aSBP, r = 0.770; AIx(75), r = 0.400; PWV, r = 0.739). The Bland-Altman Plots for aSBP and AIx(75) showed acceptable agreement between the two devices and no evidence of systemic bias for PWV.
Conclusion:
As in other populations, acceptable agreement between Mobil-O-Graph and Sphygmocor was evident for aSBP and AIx(75) in hemodialysis patients; PWV was slightly underestimated by Mobil-O-Graph.
More Related Videos
Related Concept Videos
01:21Sites for measuring blood pressure
The Brachial Artery: Primary Site for Blood Pressure Measurement
01:23Assessment of blood pressure in brachial artery(two-step method)
01:15Assessment of blood pressure in brachial artery(one-step method)
Prepare for the Procedure:
01:19Assessing Blood pressure using a doppler ultrasound
Pre-Procedural Guidelines for Doppler Ultrasound Blood Pressure Assessment:
Preparation of Equipment:
01:17Measurement of Blood Pressure
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.