Pediatric Cardiology Unit, Nantes University Hospital, Nantes, France.
Pediatric Nephrology Unit, Nantes University Hospital, Nantes, France.
PLoS One. 2020 Mar 27;15(3):e0230817. doi: 10.1371/journal.pone.0230817. eCollection 2020.
In population exposed to cardiovascular risk, aortic stiffness is an important marker which is assessed by carotid-to-femoral pulse wave velocity (PWV). In childhood, the validated applanation tonometer SphygmoCor® can be used to measure PWV, but is limited in routine practice by the child's cooperation and operator's experience. An alternative device, the pOpmètre® is validated in adults and rapidly measures finger-to-toe PWV using 2 oxymeter-like sensors. The aim of this study is to validate the pOpmètre® device in children aged between 4 and 8 years. We compared simultaneous PWV measurements of the two devices, SphygmoCor® and pOpmètre®, in a training group, using the Bland-Altman method. Then we proposed an algorithm to correct pOpmètre® PWV (PWVpop). Finally, we validated this new algorithm in a validation group of children using the Bland-Altman method. This prospective study enrolled 26 children in the training group. Mean PWVpop was 3.919 ± 0.587 m/s and mean SphygmoCor® PWV was 4.280 ± 0.383 m/s, with a difference of -0.362(CI95%(-0.546;-0.178)) m/s. A new algorithm was defined using transit time (TTpop): corrected PWVpop (m/s) = 0.150/TTpop(s) + 1.381*Height(m) + 1.148. We enrolled 24 children in the validation group. Mean corrected PWVpop was 4.231 ± 0.189 m/s and mean SphygmoCor® PWV was 4.208 ± 0.296 m/s with a corrected difference of 0.023(CI95%(-0.086;0.131)) m/s. With this algorithm correction, we found an agreement between PWV measured by the SphygmoCor® and the pOpmètre®, with a difference of less than 10%. Using this algorithm, the pOpmètre® could be used in clinical or research practice in young children exposed to cardiovascular risk. (This study was registered as NCT02991703).
在心血管风险人群中，主动脉僵硬度是一个重要的标志物，可以通过颈股脉搏波速度（PWV）来评估。在儿童中，经过验证的平板式血压计 SphygmoCor®可用于测量 PWV，但由于儿童的配合和操作者的经验，在常规实践中受到限制。替代设备 pOpmètre®在成年人中得到验证，可以使用两个类似于血氧计的传感器快速测量指-趾 PWV。本研究的目的是验证 pOpmètre®设备在 4 至 8 岁儿童中的有效性。我们使用 Bland-Altman 方法比较了 SphygmoCor®和 pOpmètre®两种设备在训练组中的同时 PWV 测量值。然后，我们提出了一种校正 pOpmètre®PWV（PWVpop）的算法。最后，我们使用 Bland-Altman 方法在验证组的儿童中验证了这个新算法。这项前瞻性研究纳入了 26 名训练组的儿童。PWVpop 的平均值为 3.919±0.587 m/s，SphygmoCor®PWV 的平均值为 4.280±0.383 m/s，差值为-0.362(CI95%(-0.546;-0.178)) m/s。使用传输时间（TTpop）定义了一个新算法：校正后的 PWVpop（m/s）=0.150/TTpop(s)+1.381*身高(m)+1.148。我们纳入了 24 名验证组的儿童。校正后的 PWVpop 的平均值为 4.231±0.189 m/s，SphygmoCor®PWV 的平均值为 4.208±0.296 m/s，校正后的差值为 0.023(CI95%(-0.086;0.131)) m/s。使用该算法校正后，我们发现 SphygmoCor®和 pOpmètre®测量的 PWV 之间具有一致性，差异小于 10%。使用该算法，pOpmètre®可在心血管风险儿童的临床或研究实践中使用。（该研究已在 ClinicalTrials.gov 注册，编号为 NCT02991703）。
