SAMRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
J Hypertens. 2022 Jan 1;40(1):65-75. doi: 10.1097/HJH.0000000000002976.
Carotid-femoral pulse wave velocity (PWV) is the gold-standard noninvasive measure of arterial stiffness. Data comparing tonometry-based devices such as the SphygmoCor XCEL to simpler brachial-cuff-based estimates of PWV, such as from the Mobil-O-Graph in African populations are sparse. We therefore aimed to compare PWV measured by the Mobil-O-Graph and the SphygmoCor XCEL device in a sample of South African women and children.
Women (n = 85) 29 years [interquartile range (IQR): 29-69] and their children/grandchildren (n = 27) 7 years (IQR: 4-11) were recruited for PWV measurement with Mobil-O-Graph and SphygmoCor XCEL on the same day. Wilcoxon signed-rank test, regression analysis, spearman correlation and Bland-Altman plots were used for PWV comparison between devices.
For adults, the SphygmoCor XCEL device had a significantly higher PWV (7.3 m/s, IQR: 6.4-8.5) compared with the Mobil-O-Graph (5.9 m/s, IQR: 5.0-8.1, P = 0.001) with a correlation coefficient of 0.809 (P ≤ 0.001). Bland--Altman analysis indicated an acceptable level of agreement but significant bias (mean difference PWV: 0.90 ± 1.02 m/s; limits of agreement: -1.10 to 2.90). The odds of having a PWV difference more than 1 m/s decreased with a higher age [odds ratio (OR): 0.95, 95% confidence interval (95% CI) = 0.92-0.98] and increased with greater height (OR: 1.10, 95% CI = 1.01-1.21, P = 0.03) in multivariable analysis. In children, the Bland-Altman indicated an excellent level of agreement (-0.03 ± 0.63 m/s; limits of agreement: -1.26 to 1.21), but no correlation was found (rs = 0.08, P = 0.71).
Particularly in younger and taller women, the Mobil-O-Graph significantly underestimated PWV compared with the SphygmoCor. Although no correlation was found between the two devices for children, further research is required due to the small sample size. Furthermore, the clinical value of both methods in young African populations requires further investigation.
颈动脉-股动脉脉搏波速度（PWV）是动脉僵硬度的非侵入性金标准测量方法。比较基于张力计的设备（如 SphygmoCor XCEL）与基于更简单的肱动脉袖带的 PWV 估计值（如 Mobil-O-Graph）的文献数据在非裔人群中相对较少。因此，我们旨在比较南非女性和儿童样本中 Mobil-O-Graph 和 SphygmoCor XCEL 设备测量的 PWV。
对 85 名年龄为 29 岁（四分位距（IQR）：29-69）的女性和 27 名年龄为 7 岁（IQR：4-11）的其子女/孙子女（n=27）进行 Mobil-O-Graph 和 SphygmoCor XCEL 同一天进行 PWV 测量。使用 Wilcoxon 符号秩检验、回归分析、Spearman 相关性和 Bland-Altman 图比较设备之间的 PWV。
对于成年人，SphygmoCor XCEL 设备的 PWV（7.3 m/s，IQR：6.4-8.5）明显高于 Mobil-O-Graph（5.9 m/s，IQR：5.0-8.1，P=0.001），相关系数为 0.809（P≤0.001）。Bland-Altman 分析表明存在可接受的一致性水平，但存在显著偏差（平均 PWV 差异：0.90±1.02 m/s；界限：-1.10 至 2.90）。多变量分析表明，PWV 差异大于 1 m/s 的可能性随年龄的增加而降低[比值比（OR）：0.95，95%置信区间（95%CI）=0.92-0.98]，而随身高的增加而增加（OR：1.10，95%CI=1.01-1.21，P=0.03）。在儿童中，Bland-Altman 表明存在极好的一致性（-0.03±0.63 m/s；界限：-1.26 至 1.21），但未发现相关性（rs=0.08，P=0.71）。
特别是在年轻和较高的女性中，Mobil-O-Graph 与 SphygmoCor 相比显著低估了 PWV。尽管在儿童中未发现两种设备之间存在相关性，但由于样本量较小，还需要进一步研究。此外，还需要进一步研究这两种方法在年轻的非洲人群中的临床价值。
