1st Department of Medicine (Cardiology, Angiology, Pulmonary and Intensive Care), University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
5th Department of Medicine (Nephrology, Hypertensiology, Endocrinology, Diabetology, Rheumatology), University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
Am J Hypertens. 2021 Apr 20;34(4):383-393. doi: 10.1093/ajh/hpaa174.
Central blood pressure becomes increasingly accepted as an important diagnostic and therapeutic parameter. Accuracy of widespread applanation tonometry can be affected by calibration and operator training. To overcome this, we aimed to evaluate novel VascAssist 2 using automated oscillometric radial pulse wave analysis and a refined multi-compartment model of the arterial tree.
Two hundred and twenty-five patients were prospectively enrolled. Invasive aortic root measurements served as reference in MEASURE-cBP 1 (n = 106) whereas applanation tonometry (SphygmoCor) was used in MEASURE-cBP 2 (n = 119).
In MEASURE-cBP 1, we found a mean overestimation for systolic values of 4 ± 12 mmHg (3 ± 10%) and 6 ± 10 mmHg (9 ± 14%) for diastolic values. Diabetes mellitus and low blood pressure were associated with larger variation. In MEASURE-cBP 2, mean overestimation of systolic values was 4 ± 4 mmHg (4 ± 4%) and 1 ± 4 mmHg (1 ± 7%) of diastolic values. Arrhythmia was significantly more frequent in invalid measurements (61 vs. 18%, P < 0.0001) which were most often due to a low quality index of SphygmoCor.
Central blood pressure estimates using VascAssist 2 can be considered at least as accurate as available techniques, even including diabetic patients. In direct comparison, automated measurement considerably facilitates application not requiring operator training and can be reliably applied even in patients with arrhythmias.
中心血压越来越被认为是一个重要的诊断和治疗参数。广泛应用的平板血压测量技术的准确性可能受到校准和操作人员培训的影响。为了克服这一问题，我们旨在评估新型 VascAssist 2 系统，该系统采用自动示波法桡动脉脉搏波分析和改良的动脉树多腔室模型。
前瞻性纳入 225 例患者。MEASURE-cBP 1 组（n = 106）采用主动脉根部有创测量作为参考，而 MEASURE-cBP 2 组（n = 119）则采用平板血压测量（SphygmoCor）。
在 MEASURE-cBP 1 中，我们发现收缩压的平均高估值为 4 ± 12 mmHg（3 ± 10%），舒张压的平均高估值为 6 ± 10 mmHg（9 ± 14%）。糖尿病和低血压与更大的变异性相关。在 MEASURE-cBP 2 中，收缩压的平均高估值为 4 ± 4 mmHg（4 ± 4%），舒张压的平均高估值为 1 ± 4 mmHg（1 ± 7%）。心律失常在无效测量中更为常见（61%比 18%，P < 0.0001），这些无效测量最常归因于 SphygmoCor 的质量指数较低。
使用 VascAssist 2 测量中心血压可以被认为至少与现有的技术一样准确，即使包括糖尿病患者。直接比较显示，自动测量技术不需要操作人员培训，操作更为简便，即使在心律失常患者中也能可靠地应用。
