Accuracy of fully automated oscillometric central aortic blood pressure measurement techniques

Abstract

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.

Comparison between invasive and non-invasive assessment of blood pressure in hypertensive disorders of pregnancy

“…In agreement with our results, Gotzmann and colleagues [14] conducted a cross-sectional study of noninvasive central BP measurement by an oscillometric automated device (Mobil-O-Graph). It showed that the automated oscillometric monitors could assess central BP with acceptable accuracy.…”

Validation study to determine the accuracy of central blood pressure measurement using the SphygmoCor XCEL cuff device in patients with severe aortic stenosis undergoing transcatheter aortic valve replacement

“…The mean difference was lower (−3 mm Hg) but dispersion was somehow larger than in general population. 10 , 11 The non-invasive metrics correlated well with the invasive ones, but correlation is not the intended statistic to consider when aiming a validation study. Having said this, the superior correlation with the central invasive pressure shown for the XCEL estimated central pressure with respect to the cuff-brachial SBP before TAVR would make it the first best candidate to be used in the calculation of non-invasive metrics related to the valvulo-arterial load in patients with AS.…”

“…8 (2) Bland-Altman analysis shows lower bias before and a larger bias after TAVR due to a more in- Nonetheless, this study did not fulfill the requirements of a validation study according to ARTERY Society protocols and in any case, the differences were outside the pass criteria. 8 The only appropriately powered and conducted validation studies for the XCEL device are Gotzmann et al 10 and Schultz et al 11 In the first study, including 502 patients, non-invasive assessment of aortic SBP was performed by both the SphygmoCor XCEL device and the Mobil-O-Graph NG device and was compared with simultaneous invasive pressure measurement (through fluid-filled catheters). The mean systolic bias of SphygmoCor XCEL device to invasively assessed aortic SBP was −5.0 ± 7.7 mm Hg and with Mobil-O-Graph NG device was slightly but significantly larger (−6.0 ± 10.4 mm Hg, p =.011).…”

Pulsatile and steady‐state 24‐hour hemodynamics in adolescents and young adults: The next steps ahead

“…Regarding accuracy, many studies have sought to determine the accuracy of the Mobil‐O‐Graph 24h PWA device for measuring brachial BP, 9,10 central BP, 4,11 wave reflections, 12,13 estimated aortic pulse wave velocity, 14,15 and stroke volume 16,17 in adults. Taken together, all studies showed at least a reasonable agreement with the reference standard.…”