Agnoletti D, Millasseau S, Topouchian J, Zhang Y, Safar M E, Blacher J
Centre de diagnostic et de thérapeutique, Paris Descartes University, Hôtel-Dieu, AP-HP, 1, place du Parvis-Notre-Dame, 75181 Paris cedex 04, France.
Ann Cardiol Angeiol (Paris). 2013 Jun;62(3):193-9. doi: 10.1016/j.ancard.2013.04.002. Epub 2013 Apr 19.
Pulse wave analysis is a pivotal instrument to estimate central hemodynamic parameters. Applanation tonometry on radial and/or carotid arteries is usually used to detect pressure waveforms. Available commercial devices have been validated against invasive catheterism, showing a good agreement of harmonics pattern. In a previous investigation, we observed differences on radial second systolic peak (rSPB2) between two commonly used devices: SphygmoCor (AtCor, Australia) and PulsePen (Diatecne, Italy). The aim of our study was to further quantify differences on radial and carotid signals from the two devices.
We measured radial and carotid pressure waveforms in 38 patients where systolic, diastolic blood pressure and heart rate presented minimal changes between measurements. Waveforms were digitally extracted for off-line analysis.
Radial rSBP2, mean arterial pressure, form factor and augmentation index were different with SphygmoCor providing lower values. Carotid augmentation index and form factor were similar. However, carotid systolic pressure (cSBP) from PulsePen was higher that cSBP from SphygmoCor (2.7 ± 4.4 mmHg, P<0.001).
PulsePen and SphygmoCor sensors are not equivalent and provide different wave shapes. These differences on wave shape have important consequences on parameters computed from these waveforms with more discrepancy on radial derived parameters such as rSBP2 and mean arterial pressure than on carotid derived parameters. Further studies are required to compare invasive pressure parameters to indices derived from these two devices.
脉搏波分析是估计中心血流动力学参数的关键手段。通常采用对桡动脉和/或颈动脉进行压平式眼压测量来检测压力波形。现有的商用设备已通过与侵入性导管插入术的验证,显示出谐波模式具有良好的一致性。在之前的一项研究中,我们观察到两种常用设备:SphygmoCor(澳大利亚AtCor公司)和PulsePen(意大利Diatecne公司)在桡动脉第二收缩峰(rSPB2)上存在差异。我们研究的目的是进一步量化这两种设备在桡动脉和颈动脉信号上的差异。
我们测量了38例患者的桡动脉和颈动脉压力波形,这些患者在测量期间收缩压、舒张压和心率的变化极小。波形通过数字方式提取用于离线分析。
桡动脉rSBP2、平均动脉压、形态因子和增强指数存在差异,SphygmoCor测得的值较低。颈动脉增强指数和形态因子相似。然而,PulsePen测得的颈动脉收缩压(cSBP)高于SphygmoCor测得的cSBP(2.7±4.4 mmHg,P<0.001)。
PulsePen和SphygmoCor传感器并不等效,且提供不同的波形。这些波形差异对从这些波形计算出的参数有重要影响,桡动脉衍生参数(如rSBP2和平均动脉压)的差异比颈动脉衍生参数更大。需要进一步研究将侵入性压力参数与从这两种设备得出的指标进行比较。