Echeverri Darío, Pizano Alejandro, Cabrales Jaime, Moreno Karen
Vascular Function Research Laboratory, Interventional Cardiology Department, Fundación CardioInfantil-Instituto de Cardiología, Calle 163 A número 13B-60, Torre H. 3 Piso, Bogotá, Colombia.
Research Department, Fundación CardioInfantil-Instituto de Cardiología, Bogotá, Colombia.
High Blood Press Cardiovasc Prev. 2018 Mar;25(1):65-77. doi: 10.1007/s40292-017-0238-8. Epub 2017 Oct 28.
Peripheral and central blood pressures are parameters of arterial stiffness and important cardiovascular risk markers. Today, there are non-invasive methods that measure these pressures.
To validate the non-invasive oscillometric method, compared with invasive pressure measurements obtained by cardiac catheterization.
An open, prospective cohort clinical study in 100 patients, 64 ± 11 years old. The measurement of peripheral and central blood pressures obtained using the Arteriograph system oscillometric method, (TensioMed, Budapest-Hungary, Ltd.) was validated in an adult population undergoing simultaneous, contralateral left cardiac catheterization (gold standard) using the radial technique, evaluating the correlation and agreement between the two methods. This study fulfils the latest standardized protocol for central blood pressure validation published by ARTERY Society.
The pressures obtained with the Arteriograph show a high correlation with the pressures measured using the gold standard. Overall, the intraclass correlation coefficient for brachial pressures was 0.80 (p < 0.001), and 0.91 (p < 0.001) for central pressures. The good agreement between the two methods was demonstrated equally by the Bland-Altman method and independent linear regressions for each variable.
The oscillometric noninvasive method employed is easy to use and valid for estimating hemodynamic variables such as central and peripheral arterial pressure, having good agreement and conformity with the gold standard in a different type of patients and conditions. This technique can help optimize cardiovascular assessment in primary and secondary prevention, enhance treatment in selected patients and it could be an important element for future cardiovascular prevention.
外周血压和中心血压是动脉僵硬度的参数以及重要的心血管风险标志物。如今,有多种非侵入性方法可测量这些血压。
与通过心导管插入术获得的侵入性压力测量结果相比,验证非侵入性示波法。
对100名年龄在64±11岁的患者进行一项开放性、前瞻性队列临床研究。使用动脉记录仪系统示波法(匈牙利布达佩斯的TensioMed有限公司)获得的外周血压和中心血压测量值,在同时进行对侧左心导管插入术(金标准)的成年人群中采用桡动脉技术进行验证,评估两种方法之间的相关性和一致性。本研究符合动脉协会发布的最新中心血压验证标准化方案。
动脉记录仪获得的血压与使用金标准测量的血压高度相关。总体而言,肱动脉血压的组内相关系数为0.80(p<0.001),中心血压的组内相关系数为0.91(p<0.001)。Bland-Altman方法和每个变量的独立线性回归均同样证明了两种方法之间的良好一致性。
所采用的示波非侵入性方法易于使用,对于估计诸如中心动脉压和外周动脉压等血流动力学变量是有效的,在不同类型的患者和条件下与金标准具有良好的一致性和符合性。该技术有助于优化一级和二级预防中的心血管评估,加强对选定患者的治疗,并且可能是未来心血管预防的重要要素。