Background: Central aortic blood pressure (cBP) is a valuable predictor of cardiovascular risk. The lack of fully automated measurement devices impeded an implementation in daily clinical practice so far. The present study compares two novel automated oscillometric devices with invasively measured cBP. Methods: From March 2017 to March 2018, we enrolled consecutive patients undergoing elective coronary angiography to this cross-sectional study. Noninvasive assessment of cBP was performed by the SphygmoCor XCEL device and the Mobil-O-Graph NG device simultaneously to invasive measurement. Results: Our study included 502 patients (228 women, 274 men) with a mean age of 67.9 ± 11.6 years. The noninvasive measurement of cBP was successful in 498 patients (99%) with SphygmoCor XCEL device and in 441 patients (88%) with Mobil-O-Graph NG device (P = 0.451). Measurements of both devices revealed a high correlation to invasively measured systolic (SphygmoCor R 2 0.864, P < 0.001; Mobil-O-Graph R 2 0.763, P < 0.001) and diastolic (SphygmoCor R 2 0.772, P < 0.001; Mobil-O-Graph R 2 0.618, P < 0.001) cBP. Both devices slightly underestimated systolic and overestimated diastolic central blood pressure: biases were −5.0 ± 7.7/0.5 ± 6.2 mmHg with SphygmoCor XCEL and −6.0 ± 10.4/3.6 ± 8.3 mmHg with Mobil-O-Graph NG device. Correlations (R 2) were higher and biases were lower with the SphygmoCor device (P < 0.001 each). Conclusion: The present study is the largest validation study of noninvasive cBP measurement techniques so far and shows that two current automated oscillometric monitors are able to assess cBP with acceptable accuracy. Automated oscillometric devices may facilitate the implementation of cBP in daily clinical practice.
Background: Two fully automated oscillometric devices have become available for the noninvasive assessment of central aortic blood pressure (BP). They tend, however, to underestimate SBP. It has been proposed that calibration by mean/diastolic instead of systolic/diastolic brachial BP may reduce this bias. The present work compares the accuracy of these two calibrations in the Mobil-O-Graph. Methods: Post-hoc analysis of the largest validation study on noninvasive assessment of central BP so far. Data on both calibration approaches were available in 159 patients without atrial fibrillation, who underwent simultaneous invasive and noninvasive assessment of central BP. Noninvasive BP measurements were conducted using the SphygmoCor XCEL (calibration by systolic/diastolic brachial BP only) and the Mobil-O-Graph (calibration by both systolic/diastolic and mean/diastolic brachial BP). Results: Measurements of both devices and both calibration methods revealed highly significant correlations for systolic and diastolic central BP with invasively assessed BP (P < 0.001 each). Calibration by mean/diastolic and systolic/diastolic BP yielded similar correlations for central DBP (R 2 0.56 vs. R 2 0.55, P = 0.919). Correlation of central SBP, however, was significantly lower using calibration by mean/diastolic brachial BP (R 2 0.86 vs. R 2 0.74, P = 0.002). Numerically, the SphygmoCor device revealed the highest correlation (R 2 0.92 for central SBP and 0.72 for central DBP; P < 0.001 each). Calibration by systolic/diastolic brachial BP was associated with an underestimation of central SBP using both the SphygmoCor and the Mobil-O-Graph. Calibration by mean/diastolic brachial BP, instead, was associated with an overestimation, which was numerically comparable (4.8 ± 11.3 vs. −4.2 ± 8.0). The calibration method had little effects on the biases of diastolic measurements. Conclusion: Calibration by mean/diastolic instead of systolic/diastolic brachial BP led to an overestimation instead of underestimation of central SBP without improving accuracy. Hence, mean/diastolic calibration is not necessarily superior to systolic/diastolic calibration and the optimal approach has to be determined in a device-specific manner.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.