Crilly Mike, Coch Christoph, Bruce Margaret, Clark Hazel, Williams David
Department of Public Health, University of Aberdeen Medical School, Aberdeen, UK. mike.crilly@ abdn.ac.uk
Vasc Med. 2007 Aug;12(3):189-97. doi: 10.1177/1358863X07081134.
Pulse wave analysis (PWA) using applanation tonometry is a non-invasive technique for assessing cardiovascular function. It produces three important indices: ejection duration index (ED%), augmentation index adjusted for heart rate (AIX@75), and subendocardial viability ratio (SEVR%). The aim of this study was to assess within- and between-observer repeatability of these measurements. After resting supine for 15 minutes, 20 ambulant patients (16 male) in sinus rhythm underwent four PWA measurements on a single occasion. Two nurses (A & B) independently and alternately undertook PWA measurements using the same equipment (Omron HEM-757; SphygmoCor with Millar hand-held tonometer) blind to the other nurse's PWA measurements. Within- and between-observer differences were analysed using the Bland-Altman ;limits of agreement' approach (mean difference +/- 2 standard deviations, 2SD). Mean age was 56 (blood pressure, BP 136/79; pulse rate 64). BP/PWA measurements remained stable during assessment. Based on the average of two PWA measurements the mean +/- 2SD between-observer difference in ED% was 0.3 +/- 2.0; AIX@75 1.0 +/- 3.9; and SEVR% 1.7 +/- 14.2. Based on a single PWA measurement the between-observer difference was ED% 0.3 +/- 3.3; AIX@75 1.7 +/- 6.9; and SEVR% 0.6 +/- 22.6. Within-observer differences for nurse-A were ED% 0.0 +/- 5.4; AIX@75 1.5 +/- 7.0; and SEVR% 1.7 +/- 39.0 (nurse-B: 0.1 +/- 3.8; 0.1 +/- 8.0; and 0.6 +/- 23.3, respectively). PWA demonstrates high levels of repeatability even when used by relatively inexperienced staff and has the potential to be included in the routine cardiovascular assessment of ambulant patients.
使用压平式眼压计进行脉搏波分析（PWA）是一种评估心血管功能的非侵入性技术。它可产生三个重要指标：射血持续时间指数（ED%）、心率校正的增强指数（AIX@75）和心内膜下存活比率（SEVR%）。本研究的目的是评估这些测量值在观察者内和观察者间的可重复性。20例窦性心律的门诊患者（16例男性）仰卧休息15分钟后，在同一时间进行了4次PWA测量。两名护士（A和B）使用相同设备（欧姆龙HEM - 757；带有米勒手持式眼压计的SphygmoCor）独立且交替进行PWA测量，对另一名护士的PWA测量结果不知情。使用Bland - Altman“一致性界限”方法（平均差异±2标准差，2SD）分析观察者内和观察者间的差异。平均年龄为56岁（血压，BP 136/79；脉搏率64）。评估期间BP/PWA测量值保持稳定。基于两次PWA测量的平均值，观察者间ED%的平均差异±2SD为0.3±2.0；AIX@75为1.0±3.9；SEVR%为1.7±14.2。基于单次PWA测量，观察者间差异为ED% 0.3±3.3；AIX@75 1.7±6.9；SEVR% 0.6±22.6。护士A的观察者内差异为ED% 0.0±5.4；AIX@75 1.5±7.0；SEVR% 1.7±39.0（护士B分别为0.1±3.8；0.1±8.0；0.6±23.3）。即使由经验相对不足的工作人员使用，PWA也显示出高度的可重复性，并且有可能纳入门诊患者的常规心血管评估中。
