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日常临床实践中动脉僵硬度的示波法评估。

Oscillometric assessment of arterial stiffness in everyday clinical practice.

作者信息

Reshetnik Alexander, Gohlisch Christopher, Tölle Markus, Zidek Walter, Van Der Giet Markus

机构信息

Department of Nephrology and Transplantation, Charité University Berlin, Campus Benjamin Franklin, Berlin, Germany.

出版信息

Hypertens Res. 2017 Feb;40(2):140-145. doi: 10.1038/hr.2016.115. Epub 2016 Sep 8.

Abstract

Measurement of carotid-femoral pulse wave velocity (cfPWV) is considered the gold standard for assessing arterial stiffness. Although widely used in clinical and observational studies, the detection of cfPWV has not yet been applied in everyday clinical practice due to technical and procedural difficulties. We, therefore, evaluated the applicability of oscillometric cfPWV assessment for everyday clinical practice. Eighty-nine patients were prospectively included in the study. Oscillometric calculations of cfPWV were performed with Tel-O-GRAPH and tonometric calculations with Sphygmocor. The accuracy, reproducibility, reliability and robustness of Tel-O-GRAPH calculations in different clinical situations were evalu??ated. The mean study population age was 48.8±19.1 years. More than half (59.6%) of the patients were male, and 15.1% were smokers. The mean difference of PWV between devices was 0.49±1.26 m s (P<0.0001), and the Pearson correlation index was 0.86 (P<0.0001). The coefficient of variation and intraclass correlation coefficients between three single measured PWV values with the Tel-O-GRAPH and Sphygmocor were 2.38±6.13% vs. 6.3±4.33% (P<0.05) and 0.99; 0.99; and 0.99 vs. 0.78; 0.84; and 0.71, respectively. For Tel-O-GRAPH, there was no statistically significant difference between PWV in seated vs. supine positions or by experienced or inexperienced users. High reproducibility and reliability of the calculated single PWV values with Tel-O-GRAPH and considerable performance accuracy compared with Sphygmocor were observed. The reported evidence suggests that oscillometry might evolve as a favored method for the assessment of the PWV in everyday clinical practice and in clinical studies due to its ease of use, accuracy and robustness.

摘要

测量颈股脉搏波速度(cfPWV)被认为是评估动脉僵硬度的金标准。尽管cfPWV检测在临床和观察性研究中广泛应用,但由于技术和操作上的困难,尚未应用于日常临床实践。因此,我们评估了示波法cfPWV评估在日常临床实践中的适用性。本研究前瞻性纳入了89例患者。使用Tel-O-GRAPH进行cfPWV的示波法计算,使用Sphygmocor进行压平式测压法计算。评估了Tel-O-GRAPH计算在不同临床情况下的准确性、可重复性、可靠性和稳健性。研究人群的平均年龄为48.8±19.1岁。超过一半(59.6%)的患者为男性,15.1%为吸烟者。两种设备之间PWV的平均差异为0.49±1.26 m/s(P<0.0001),Pearson相关指数为0.86(P<0.0001)。使用Tel-O-GRAPH和Sphygmocor单次测量的三个PWV值之间的变异系数和组内相关系数分别为2.38±6.13%对6.3±4.33%(P<0.05)以及0.99;0.99;0.99对0.78;0.84;0.71。对于Tel-O-GRAPH,坐位与仰卧位的PWV之间或经验丰富与经验不足的使用者之间均无统计学显著差异。观察到使用Tel-O-GRAPH计算的单次PWV值具有高可重复性和可靠性,与Sphygmocor相比性能准确性相当。报道的证据表明,由于示波法使用方便、准确性高且稳健,它可能会成为日常临床实践和临床研究中评估PWV的首选方法。

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