Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea.
Hypertens Res. 2012 Dec;35(12):1180-4. doi: 10.1038/hr.2012.113. Epub 2012 Jul 26.
Arterial stiffness is a known independent predictor of cardiovascular mortality. The Colins system is an easy device and has gained widespread use, but the cutoff value for high-risk central arterial stiffness is not well established. We investigated the correlation between arterial stiffness measured by the Colins system with conventional measurements from the SphygmoCor system. Arterial pulse wave velocity (PWV) and augmentation indices (AIs) were measured on a single visit using two different devices in 948 patients with hypertension or coronary artery disease. Strong positive correlations were observed for PWV values measured by the SphygmoCor and Colins systems. The Colins system measurements accurately predicted high-risk central arterial stiffness, defined as carotid-femoral PWV≥12 m s(-1), with an area under the receiver-operating characteristic curve (AUC) of 0.884 (heart-femoral PWV, hfPWV) and 0.830 (brachial-ankle PWV, baPWV) in the training set (N=664). The cutoff values, 11.18 (hfPWV) and 16.17 m s(-1) (baPWV), showed good discrimination in the validation set (N=284), with sensitivity of 83.3 (hfPWV) and 76.0% (baPWV), and specificity of 74.9 (hfPWV) and 82.6% (baPWV). The SphygmoCor and Colins AI systems also showed moderate positive correlation. The Colins AI system better predicted high-risk central pulse pressure as defined by pulse pressure≥50 mm Hg (AUC: Colins, 0.765; SphygmoCor, 0.692; P=0.011). Arterial stiffness measured by the Colins system showed strong positive correlation and agreement with the SphygmoCor system measurement. Cutoff values for high-risk central arterial stiffness in the Colins system need further validation in a prospective study.
动脉僵硬度是心血管死亡率的一个已知的独立预测因子。科林斯系统是一种简单易用的设备，已经得到了广泛的应用，但高危中心动脉僵硬度的截断值尚未得到很好的确定。我们研究了科林斯系统测量的动脉僵硬度与 SphygmoCor 系统的常规测量之间的相关性。在 948 例高血压或冠心病患者中，使用两种不同的设备在单次就诊时测量了脉搏波速度（PWV）和增强指数（AI）。使用 SphygmoCor 和科林斯系统测量的 PWV 值之间存在很强的正相关。科林斯系统的测量结果准确地预测了高危中心动脉僵硬度，定义为颈-股 PWV≥12 m/s，在训练集（N=664）中，ROC 曲线下面积（AUC）为 0.884（心-股 PWV，hfPWV）和 0.830（肱-踝 PWV，baPWV）。在验证集（N=284）中，11.18（hfPWV）和 16.17 m/s（baPWV）的截断值具有良好的区分度，敏感性分别为 83.3%（hfPWV）和 76.0%（baPWV），特异性分别为 74.9%（hfPWV）和 82.6%（baPWV）。SphygmoCor 和科林斯 AI 系统也显示出中度正相关。科林斯 AI 系统更好地预测了定义为脉压≥50mmHg 的高危中心脉搏压（AUC：科林斯系统为 0.765，SphygmoCor 系统为 0.692，P=0.011）。科林斯系统测量的动脉僵硬度与 SphygmoCor 系统的测量值具有很强的正相关和一致性。科林斯系统中高危中心动脉僵硬度的截断值需要在一项前瞻性研究中进一步验证。
