Aortic pressure and forward and backward wave components in children, adolescents and young-adults: Agreement between brachial oscillometry, radial and carotid tonometry data and analysis of factors associated with their differences

Abstract

Non-invasive devices used to estimate central (aortic) systolic pressure (cSBP), pulse pressure (cPP) and forward (Pf) and backward (Pb) wave components from blood pressure (BP) or surrogate signals differ in arteries studied, techniques, data-analysis algorithms and/or calibration schemes (e.g. calibrating to calculated [MBPc] or measured [MBPosc] mean pressure). The aims were to analyze, in children, adolescents and young-adults (1) the agreement between cSBP, cPP, Pf and Pb obtained using carotid (CT) and radial tonometry (RT) and brachial-oscillometry (BOSC); and (2) explanatory factors for the differences between approaches-data and between MBPosc and MBPc.1685 subjects (mean/range age: 14/3-35 y.o.) assigned to three age-related groups (3–12; 12–18; 18–35 y.o.) were included. cSBP, cPP, Pf and Pb were assessed with BOSC (Mobil-O-Graph), CT and RT (SphygmoCor) records. Two calibration schemes were considered: MBPc and MBPosc for calibrations to similar BP levels. Correlation, Bland-Altman tests and multiple regression models were applied. Systematic and proportional errors were observed; errors´ statistical significance and values varied depending on the parameter analyzed, methods compared and group considered. The explanatory factors for the differences between data obtained from the different approaches varied depending on the methods compared. The highest cSBP and cPP were obtained from CT; the lowest from RT. Independently of the technique, parameter or age-group, higher values were obtained calibrating to MBPosc. Age, sex, heart rate, diastolic BP, body weight or height were explanatory factors for the differences in cSBP, cPP, Pf or Pb. Brachial BP levels were explanatory factors for the differences between MBPosc and MBPc.

Physiological Age- and Sex-Related Profiles for Local (Aortic) and Regional (Carotid-Femoral, Carotid-Radial) Pulse Wave Velocity and Center-to-Periphery Stiffness Gradient, with and without Blood Pressure Adjustments: Reference Intervals and Agreement between Methods in Healthy Subjects (3–84 Years)

“…The study was carried out in the context of the Centro Universitario de Investigación, Innovación y Diagnóstico Arterial (CUiiDARTE) project [ 9 , 10 , 11 , 12 , 13 ], a population-based study developed in Uruguay. In this work, we considered data from 3619 subjects included in the CUiiDARTE Database.…”

“…CV evaluation in the CUiiDARTE project includes assessing: (i) peripheral (brachial, radial, ankle) and central (aortic, carotid) BP levels; central (aortic, carotid) PWA and WSA-derived parameters (e.g., augmentation index, forward and backward pressure components), (ii) carotid, femoral and brachial beat-to-beat diameter waves and intima-media thickness, (iii) brachial artery reactivity (e.g., flow-mediated dilation; low flow-mediated constriction), (iv) carotid, femoral and brachial doppler-derived blood velocity profiles and resistive/pulsatile indexes, (v) ankle-brachial index, (vi) screening for carotid and femoral atherosclerotic plaques presence, (vii) carotid, femoral and brachial local stiffness (e.g., distensibility, elastic modulus), (viii) systemic hemodynamic evaluation (e.g., systemic vascular resistances, cardiac output and index quantified from brachial pulse contour analysis and/or cardiography impedance, (ix) regional stiffness (cfPWV, crPWV) [ 9 , 10 , 11 , 12 , 13 , 22 ]. In this work, we focused on regional and local PWV data.…”

“…Central BP levels and waveforms were obtained (random order) using two commercially available devices: SphygmoCor-CvMS (SCOR; v.9, AtCor-Medical, Australia) and Mobil-O-Graph PWA-monitor system (MOG; I.E.M.-GmbH, Stolberg, Germany) ( Figure 1 ). Both devices and systems enable PWA and WSA [ 12 ]. A detailed (step-by-step) explanation of the method used for WSA based on recorded (carotid wave, SCOR) and mathematicallyderived aortic wave (SCOR and MOG) was included in a previous work as Supplementary Material [ 12 ].…”

Carotid and Femoral Atherosclerotic Plaques in Asymptomatic and Non-Treated Subjects: Cardiovascular Risk Factors, 10-Years Risk Scores, and Lipid Ratios’ Capability to Detect Plaque Presence, Burden, Fibro-Lipid Composition and Geometry

“…The study was carried out in the context of the Centro Universitario de Investigación, Innovación y Diagnóstico Arterial (CUiiDARTE) Project [16][17][18][19]. We considered data from a total of 581 subjects (47% females) provided by CUiiDARTE Database.…”

“…Waves were calibrated to pDBP and pMBP and a generalized transfer function was applied to obtain central aortic blood pressure (cBP) waveforms and to quantify central systolic, diastolic and pulse (cSBP, cDBP, cPP, respectively) pressure levels. Only accurate waveforms on visual inspection and high-quality recordings (in-device quality index >75%) were considered [16].…”