Hypertension Center STRIDE-7, National and Kapodistrian University of Athens, School of Medicine, Third Department of Medicine, Sotiria Hospital, Athens, Greece.
J Hypertens. 2024 Sep 1;42(9):1538-1543. doi: 10.1097/HJH.0000000000003753. Epub 2024 Apr 25.
A novel automated auscultatory upper-arm cuff blood pressure (BP) monitor for office use (KOROT P3 Accurate, previously InBody BPBIO480KV), which displays Korotkoff sound curves for each BP reading was recently developed. This study investigated whether the review of Korotkoff sound curves by healthcare professionals further improves the accuracy of the device by identifying unreliable BP readings.
Three observers assessed independently the morphology of Korotkoff sound curves of BP measurements obtained during an ISO 81060-2:2018 validation study, and classified them as of good, fair, or poor quality (low amplitude or sound intensity, aberrant morphology, background noise, signal artifact, auscultatory gap, irregular rhythm). The observers were blinded to the study BP measurements.
Korotkoff sound curves of 255 BP readings obtained in 85 individuals were analyzed (mean age 57.3 ± 15.0 years, 53 men). Of the SBP readings 80.4/12.2/7.4% were classified as good/fair/poor, and DBP 76.9/12.2/10.9%. Inter-observer agreement in detecting poor-quality curves was 84.7/83.1% (systolic/diastolic). Of poor-quality curves, 10.5/60.7% (systolic/diastolic) clustered in the same individuals. The validation criterion 1 [mean test-reference BP difference ≤5 ± 8 (SD) mmHg] was satisfied for readings with good (0.1 ± 4.9/0.3 ± 3.8 mmHg, systolic/diastolic) and fair-quality curves (-0.4 ± 6.4/0.2 ± 5.0), but not for poor-quality ones (2.7 ± 8.8/3.6 ± 8.1). By excluding poor-quality readings (40 of 255), criterion 1 of the validation study was improved (0.2 ± 4.9/0.2 ± 3.9 versus 0.3 ± 5.5/0.6 ± 4.7 mmHg).
The visual assessment of Korotkoff sounds generated during automated auscultatory BP measurement by the KOROT P3 Accurate professional monitor identifies unreliable readings and further improves the device accuracy.
最近开发了一种新型的自动听诊式上臂袖带血压（BP）监测仪，可用于办公室（KOROT P3 Accurate，之前称为 InBody BPBIO480KV），该监测仪可显示每个 BP 读数的柯氏音曲线。本研究旨在通过识别不可靠的 BP 读数，探讨医疗保健专业人员对柯氏音曲线的评估是否能进一步提高设备的准确性。
三名观察者独立评估了 ISO 81060-2：2018 验证研究中获得的 BP 测量的柯氏音曲线的形态，并将其分类为质量良好、中等或差（低幅度或声音强度、异常形态、背景噪声、信号伪影、听诊间隙、不规则节律）。观察者对研究中的 BP 测量值是盲的。
对 85 名个体的 255 次 BP 读数的柯氏音曲线进行了分析（平均年龄 57.3±15.0 岁，53 名男性）。SBP 读数中，80.4/12.2/7.4%被分类为良好/中等/差，DBP 为 76.9/12.2/10.9%。在检测质量差的曲线时，三名观察者之间的一致性为 84.7/83.1%（收缩压/舒张压）。质量差的曲线中，10.5/60.7%（收缩压/舒张压）在同一个体中聚集。验证标准 1[平均测试-参考 BP 差值≤5±8（SD）mmHg]适用于质量良好（0.1±4.9/0.3±3.8mmHg，收缩压/舒张压）和中等质量（-0.4±6.4/0.2±5.0）的曲线，但不适用于质量差的曲线（2.7±8.8/3.6±8.1）。通过排除质量差的读数（255 次读数中的 40 次），验证研究的标准 1得到了改善（0.2±4.9/0.2±3.9 与 0.3±5.5/0.6±4.7mmHg）。
KOROT P3 Accurate 专业监测仪在自动听诊式 BP 测量过程中生成的柯氏音的视觉评估可识别不可靠的读数，并进一步提高设备的准确性。
