Rajzer Marek W, Wojciechowska Wiktoria, Klocek Marek, Palka Ilona, Brzozowska-Kiszka Małgorzata, Kawecka-Jaszcz Kalina
1st Department of Cardiology and Hypertension, Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland.
J Hypertens. 2008 Oct;26(10):2001-7. doi: 10.1097/HJH.0b013e32830a4a25.
New 2007 European Society of Hypertension guidelines recommend measuring arterial stiffness in patients with arterial hypertension, suggesting a carotid-femoral pulse wave velocity over 12 m/s as an estimate of subclinical organ damage. Considering this cutoff point, it is worth exploring whether or not there are significant differences in results obtained using various techniques for measuring aortic pulse wave velocity. The aim of the study was to compare aortic pulse wave velocity measurements using Complior, SphygmoCor, and Arteriograph devices, and to assess the effect of pulse wave transit time and traveled distance on pulse wave velocity values.
Aortic pulse wave velocity was measured on a single visit, using these devices, in randomized order, in a group of 64 patients with grade 1 or 2 arterial hypertension.
Aortic pulse wave velocity measured using Complior (10.1 +/- 1.7 m/s) was significantly higher than that obtained using SphygmoCor (8.1 +/- 1.1 m/s) or Arteriograph (8.6 +/- 1.3 m/s). No differences were noted between pulse wave velocity measurements using SphygmoCor and Arteriograph. Between-method comparison revealed that differences in traveled distance were significant: Complior versus Arteriograph [0.09 m, Confidence interval (CI): 0.08-0.12 m, P < 0.05], Complior versus SphygmoCor (0.15 m, CI: 0.13-0.16 m, P < 0.05), Arteriograph versus SphygmoCor (0.05 m, CI: 0.03-0.07 m, P < 0.05). No between-method differences were found for transit times.
Differences in pulse wave velocity obtained by compared devices resulted primarily from using various methods for measuring traveled distance. It appears reasonable to establish uniform principles for the measurement of traveled distance. Because a large number of prognosis/survival studies used direct distance between carotid and femoral sites of pulse wave recording, this distance should be mostly recommended.
2007年欧洲高血压学会新指南建议对高血压患者测量动脉僵硬度，提出颈股脉搏波速度超过12米/秒可作为亚临床器官损害的一个指标。考虑到这个临界值，探讨使用各种技术测量主动脉脉搏波速度所获结果是否存在显著差异很有必要。本研究的目的是比较使用Complior、SphygmoCor和Arteriograph设备测量主动脉脉搏波速度，并评估脉搏波传播时间和传播距离对脉搏波速度值的影响。
对64例1级或2级高血压患者进行单次就诊检查，使用这些设备按随机顺序测量主动脉脉搏波速度。
使用Complior测量的主动脉脉搏波速度（10.1±1.7米/秒）显著高于使用SphygmoCor（8.1±1.1米/秒）或Arteriograph（8.6±1.3米/秒）测量的结果。使用SphygmoCor和Arteriograph测量的脉搏波速度之间未发现差异。方法间比较显示，传播距离存在显著差异：Complior与Arteriograph相比[0.09米，置信区间（CI）：0.08 - 0.12米，P < 0.05]，Complior与SphygmoCor相比（0.15米，CI：0.13 - 0.16米，P < 0.05），Arteriograph与SphygmoCor相比（0.05米，CI：0.03 - 0.07米，P < 0.05）。传播时间在方法间未发现差异。
比较设备所获脉搏波速度的差异主要源于测量传播距离的方法不同。制定统一的传播距离测量原则似乎是合理的。鉴于大量预后/生存研究使用脉搏波记录的颈动脉和股动脉部位之间的直接距离，应优先推荐该距离。
