对动脉僵硬度升高的老年人进行示波法和压平眼压测量。

Oscillometry and applanation tonometry measurements in older individuals with elevated levels of arterial stiffness.

作者信息

van Dijk Suzanne C, Enneman Anke W, Swart Karin M A, van Schoor Natasja M, Uitterlinden Andre G, Smulders Yvo M, van den Meiracker Anton H, van der Velde Nathalie, Mattace-Raso Francesco U S

机构信息

aDepartment of Internal Medicine, Erasmus Medical Center, Rotterdam bDepartment of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Center cDepartment of Internal Medicine, Institute for Cardiovascular Research ICaR-VU, VU University Medical Center dDepartment of Internal Medicine, Section of Geriatrics, Academic Medical Center, Amsterdam eNetherlands Consortium for Healthy Aging, Rotterdam, Leiden, The Netherlands.

出版信息

Blood Press Monit. 2013 Dec;18(6):332-8. doi: 10.1097/MBP.0000000000000009.

DOI:10.1097/MBP.0000000000000009

PMID:24192847

Abstract

OBJECTIVE

Indices of arterial stiffness and aortic pressure are usually assessed by applanation tonometry. The more recently introduced oscillometric device is simpler to use. Several studies have investigated the agreement between these two devices, but not in populations with elevated levels of arterial stiffness. Therefore, we evaluated the agreement in an elderly population with high risk of arterial stiffness.

PATIENTS AND METHODS

We included a subgroup of the B-PROOF study (n=344, mean age 73 years, 60% men), whose aortic pulse wave velocity (aPWV), aortic augmentation index (AIx), aortic pulse pressure (PP), and aortic systolic blood pressure (SBP) were assessed both with applanation tonometry (SphygmoCor) and with oscillometry (Arteriograph). We investigated agreement between the two devices using Pearson correlations and Bland-Altman analysis. We carried out a stratified analysis in participants with more pronounced arterial stiffness (SphygmoCor aPWV>12 m/s).

RESULTS

The oscillometric method produced higher values of AIx, aortic PP, and aortic SBP (P<0.01) than applanation tonometry. aPWV values were lower (P<0.01) and were not correlated (r=-0.06, P=0.92), whereas AIx measurements (r=0.35 P<0.01), aortic PP (r=0.57 P<0.01), and aortic SBP (r=0.68 P<0.01) measurements were correlated. Bland-Altman analysis showed insufficient agreement between the two devices, especially in those with elevated levels of arterial stiffness (aPWV>12 m/s).

CONCLUSION

Particularly in the elderly with elevated levels of arterial stiffness, measurements of aPWV obtained with oscillometry and applanation tonometry show poor agreement. Also, AIx, aortic SBP, and aortic PP show clearly less than optimal agreement.

摘要

目的

动脉僵硬度和主动脉压力指标通常通过压平式眼压计进行评估。最近推出的示波法设备使用起来更简单。多项研究调查了这两种设备之间的一致性，但未涉及动脉僵硬度水平升高的人群。因此，我们评估了在动脉僵硬度高风险的老年人群中的一致性。

患者与方法

我们纳入了B-PROOF研究的一个亚组（n = 344，平均年龄73岁，60%为男性），其主动脉脉搏波速度（aPWV）、主动脉增强指数（AIx）、主动脉脉压（PP）和主动脉收缩压（SBP）均通过压平式眼压计（SphygmoCor）和示波法（Arteriograph）进行评估。我们使用Pearson相关性分析和Bland-Altman分析来研究这两种设备之间的一致性。我们对动脉僵硬度更明显（SphygmoCor aPWV>12 m/s）的参与者进行了分层分析。

结果

示波法测得的AIx、主动脉PP和主动脉SBP值高于压平式眼压计（P<0.01）。aPWV值较低（P<0.01）且无相关性（r = -0.06，P = 0.92），而AIx测量值（r = 0.35，P<0.01）、主动脉PP（r = 0.57，P<0.01）和主动脉SBP（r = 0.68，P<0.01）测量值具有相关性。Bland-Altman分析显示这两种设备之间的一致性不足，尤其是在动脉僵硬度水平升高（aPWV>12 m/s）的人群中。