Butlin Mark, Qasem Ahmad
Department of Biomedical Sciences, Faculty of Medical and Health Sciences, Macquarie University, NSW, Australia.
Department of Biomedical Sciences, Faculty of Medical and Health Sciences, Macquarie University, NSW, Australia; AtCor Medical, Sydney, NSW, Macquarie University, NSW, Australia.
Pulse (Basel). 2017 Jan;4(4):180-192. doi: 10.1159/000452448. Epub 2016 Dec 1.
Large artery stiffness assessment has been an integral part of the SphygmoCor technology since 1998. Aortic stiffness is approximated with non-invasive measurement of carotid-femoral pulse wave velocity, with improvements made with time to make the assessment procedure quicker and more user independent. Also standard in the devices is the ability to reliably calculate the central aortic waveform shape from a peripheral pressure waveform from either the brachial or radial artery. This waveform contains much information beyond peak and trough (systolic and diastolic pressure). Relative waveform features such as the augmentation index, wave reflection magnitude, reflection time index, and subendocardial viability ratio are parameters that are influenced by the stiffness of systemic arteries. This article briefly describes these parameters related to large artery stiffness and provides reference to validation and repeatability studies relative to the clinical use of the SphygmoCor devices. It is beyond the scope to review here the 424 original research articles that have employed SphygmoCor devices in measuring arterial stiffness. Instead, the method of measurement across the devices is described, including tonometry, volumetric displacement through cuff placement around limbs, and ambulatory monitoring. Key population and subpopulation studies are cited where the average stiffness parameter progression with age and gender, as measured by SphygmoCor devices, is quantified in the healthy and general population. Finally, with reference to guidelines from working groups on arterial stiffness and hypertension, the clinical utility of large artery stiffness measurement is discussed in the context of the arterial stiffness parameters provided by the SphygmoCor systems.
自1998年以来，大动脉僵硬度评估一直是SphygmoCor技术的一个组成部分。通过无创测量颈股脉搏波速度来估算主动脉僵硬度，随着时间的推移不断改进，使评估过程更快且更独立于用户操作。这些设备的标准功能还包括能够根据肱动脉或桡动脉的外周压力波形可靠地计算中心主动脉波形形状。该波形包含的信息远不止峰值和谷值（收缩压和舒张压）。诸如增强指数、波反射幅度、反射时间指数和心内膜下存活比率等相对波形特征是受全身动脉僵硬度影响的参数。本文简要描述了这些与大动脉僵硬度相关的参数，并提供了与SphygmoCor设备临床应用相关的验证和重复性研究的参考文献。在此回顾424篇使用SphygmoCor设备测量动脉僵硬度的原始研究文章超出了本文的范围。相反，本文描述了这些设备的测量方法，包括眼压测量法、通过在肢体周围放置袖带进行容积位移测量以及动态监测。引用了关键人群和亚人群研究，其中量化了通过SphygmoCor设备测量的健康人群和普通人群中平均僵硬度参数随年龄和性别的变化情况。最后，参照动脉僵硬度和高血压工作组的指南，在SphygmoCor系统提供的动脉僵硬度参数背景下讨论了大动脉僵硬度测量的临床效用。
