Naidu Madireddy Umamaheshwar Rao, Reddy Budda Muralidhar, Yashmaina Sridhar, Patnaik Amar Narayana, Rani Pingali Usha
Department of Clinical Pharmacology & Therapeutics, Nizam's Institute of Medical Sciences, Punjagutta, Hyderabad, 500082, India.
Biomed Eng Online. 2005 Aug 23;4:49. doi: 10.1186/1475-925X-4-49.
Availability of a range of techniques and devices allow measurement of many variables related to the stiffness of large or medium sized arteries. There is good evidence that, pulse wave velocity is a relatively simple measurement and is a good indicator of changes in arterial properties. The pulse wave velocity calculated from pulse wave recording by other methods like doppler or tonometry is tedious, time-consuming and above all their reproducibility depends on the operator skills. It requires intensive resource involvement. For epidemiological studies these methods are not suitable. The aim of our study was to clinically evaluate the validity and reproducibility of a new automatic device for measurement of pulse wave velocity that can be used in such studies.
In 44 subjects including normal healthy control and patients with coronary artery disease, heart brachial, heart ankle, brachial ankle and carotid femoral pulse wave velocities were recorded by using a new oscillometric device. Lead I and II electrocardiogram and pressure curves were simultaneously recorded. Two observers recorded the pulse wave velocity for validation and one observer recorded the velocity on two occasions for reproducibility.
Pulse wave velocity and arterial stiffness index were recorded in 24 control and 20 coronary artery disease patients. All the velocities were significantly high in coronary artery disease patients. There was highly significant correlation between the values noted by the two observers with low standard deviation. The Pearson's correlation coefficient for various velocities ranged from (r = 0.88-0.90) with (p < 0.0001). The reproducibility was also very good as shown by Bland-Altman plot; most of the values were lying within 2 SD. The interperiod measurements of pulse wave velocity were also significantly correlated (r = 0.71-0.98) (P < 0.0001). Carotid-femoral pulse wave velocity was found to correlate significantly with heart brachial, heart ankle, brachial ankle pulse wave velocity and arterial stiffness index values. Reproducibility of our method was good with very low variability in both interobserver and interperiod analysis.
The new device "PeriScope" based on oscillometric technique has been found to be a simple, non-invasive and reproducible device for the assessment of pulse wave velocity and can be used to determine arterial stiffness in large population based studies.
一系列技术和设备的可用性使得能够测量许多与大中型动脉僵硬度相关的变量。有充分证据表明,脉搏波速度是一种相对简单的测量方法,并且是动脉特性变化的良好指标。通过多普勒或眼压测量法等其他方法从脉搏波记录中计算出的脉搏波速度既繁琐又耗时,最重要的是其可重复性取决于操作人员的技能。这需要大量资源投入。对于流行病学研究而言,这些方法并不适用。我们研究的目的是临床评估一种可用于此类研究的新型自动脉搏波速度测量设备的有效性和可重复性。
在44名受试者中,包括正常健康对照者和冠心病患者,使用一种新型示波装置记录心脏-肱动脉、心脏-踝动脉、肱动脉-踝动脉和颈动脉-股动脉的脉搏波速度。同时记录I导联和II导联心电图以及压力曲线。两名观察者记录脉搏波速度以进行有效性验证,一名观察者在两个不同时间记录速度以评估可重复性。
在24名对照者和20名冠心病患者中记录了脉搏波速度和动脉僵硬度指数。冠心病患者的所有速度均显著升高。两名观察者记录的值之间存在高度显著的相关性,标准差较低。各种速度的Pearson相关系数范围为(r = 0.88 - 0.90),(p < 0.0001)。如Bland-Altman图所示,可重复性也非常好;大多数值落在2个标准差范围内。脉搏波速度的不同时间段测量也显著相关(r = 0.71 - 0.98)(P < 0.0001)。发现颈动脉-股动脉脉搏波速度与心脏-肱动脉、心脏-踝动脉、肱动脉-踝动脉脉搏波速度以及动脉僵硬度指数值显著相关。我们方法的可重复性良好,在观察者间和时间段分析中变异性都非常低。
基于示波技术的新型设备“PeriScope”已被发现是一种用于评估脉搏波速度的简单、无创且可重复的设备,可用于基于大样本人群的研究中确定动脉僵硬度。