Pichler Gernot, Martinez Fernando, Vicente Antonio, Solaz Elena, Calaforra Oscar, Redon Josep
aHypertension Clinic. Department of Internal Medicine, Clinical Hospital of Valencia, INCLIVA, University of Valencia, Valencia bCIBEROBn, Carlos III Health Institute, Madrid, Spain.
J Hypertens. 2015 Sep;33(9):1868-75; discussion 1875. doi: 10.1097/HJH.0000000000000631.
Several devices are available for carotid-femoral pulse wave velocity (cfPWV) measurement, and a cut-off value for reference cfPWV has been established. However, discrepancies between devices have been reported.
The aim of the study was to establish the concordance of two common techniques (Complior and SphygmoCor), taking into account the anatomical distance between the measurement sites, and to investigate the impact on cardiovascular risk stratification.
cfPWV, central and peripheral blood pressure were assessed in patients attending the hypertension outpatient clinic. The subtracted carotid-femoral distance was estimated both according to the manufacturer's recommendations and correcting the obtained values by 10.3%. Bland-Altman plots, Pearson's correlation coefficient, Lin's concordance correlation coefficient and multivariate models were used to investigate the difference in cfPWV.
cfPWV assessed in 118 patients (age 55 ± 12 years, 61% hypertensive patients, BMI 28.9 ± 4.4 kg/m2) with the Complior device was lower than that assessed with the SphygmoCor device, regardless of correcting the subtracted carotid-femoral distance (8.7 vs. 10.3 m/s and 9.3 m/s, respectively; P value < 0.001). The average difference was -1.59 ± 1.5 and -0.617 ± 1.39 m/s for corrected and uncorrected SphygmoCor values, respectively, SBP, BMI and female being the main determinants of the difference. Cardiovascular risk stratification changed in up to 40% of the study population, depending on the device and the arterial distance estimation.
The concordance between the Complior and the SphygmoCor device is poor when the anatomical artery length is controlled for and in the presence of cardiovascular risk factors, resulting in a difference in classification of cardiovascular risk.
有几种设备可用于测量颈股脉搏波速度（cfPWV），并且已经确定了参考cfPWV的截断值。然而，已有报道称不同设备之间存在差异。
本研究的目的是考虑测量部位之间的解剖距离，确定两种常用技术（Complior和SphygmoCor）的一致性，并研究其对心血管风险分层的影响。
对高血压门诊患者进行cfPWV、中心和外周血压评估。根据制造商的建议估计颈股距离差值，并将获得的值校正10.3%。使用Bland-Altman图、Pearson相关系数、Lin一致性相关系数和多变量模型来研究cfPWV的差异。
无论是否校正颈股距离差值，使用Complior设备评估的118例患者（年龄55±12岁，61%为高血压患者，BMI 28.9±4.4kg/m²）的cfPWV均低于使用SphygmoCor设备评估的结果（分别为8.7与10.3m/s和9.3m/s；P值<0.001）。校正和未校正的SphygmoCor值的平均差值分别为-1.59±1.5和-0.617±1.39m/s，收缩压、BMI和女性是差异的主要决定因素。根据设备和动脉距离估计，高达40%的研究人群的心血管风险分层发生了变化。
在控制解剖动脉长度且存在心血管危险因素的情况下，Complior和SphygmoCor设备之间的一致性较差，导致心血管风险分类存在差异。
