Automated oscillometric blood pressure and pulse-wave acquisition for evaluation of vascular stiffness in atherosclerosis

Abstract

ObjectiveEvaluation of diagnostic accuracy of an oscillometry-based device (VascAssist) combining fully automated ankle-brachial index (ABI) and pulse-wave velocity (PWV) assessment for detection of peripheral arterial disease (PAD).Subjects and methods110 consecutive subjects including symptomatic PAD patients (n = 41) and healthy PAD-free participants (n = 69) were recruited. All subjects underwent standard manual Doppler-based ABI (sABI) and oscillometry-based automated ABI (aABI) measurements (VascAssist). Oscillometry by the VascAssist included central and peripheral PWV assessment. Additionally, arterial stiffness (AS) was evaluated by flow-mediated vasodilation (FMD) of the brachial artery in all patients. All symptomatic PAD patients underwent catheter angiography for endovascular intervention and post-interventional acquisition of sABI, aABI, PWV and FMD.ResultsSensitivity, specificity, PPV and NPV of aABI for detecting PAD was 73%, 100%, 100%, and 86% as compared to 80%, 96%, 92%, and 89% for sABI. Pearson-correlation for diabetics was r = 0.81; (P < .001) and for non-diabetics r = 0.77; (P < .001). Bland–Altman-analysis revealed a difference (95% CI) for diabetics of 0.09 (−0.22–0.4] and non-diabetics 0.022 [−0.25–0.295]. Weak correlation exists for FMD/AS analysis (pre-interventional R = 0.386, P = .043; post-interventional R = −0.06; P = .76) and significant increase of pre-/post-interventional PWV analysis (P < .001).ConclusionCombined automatic ABI and PWV acquisition with the VascAssist device showed excellent diagnostic accuracy for detection of PAD. Compared to FMD, AS analysis may serve as an investigator-independent (screening) tool for determination of functional vascular damage in atherosclerosis.

Brachial–ankle pulse wave velocity is independently associated with urine albumin-to-creatinine ratio in a Chinese community-based cohort

“…Another limitation is that baPWV was used instead of cfPWV, which is the gold standard. However, as several studies have demonstrated that baPWV and cfPWV are equally related to cardiovascular risk factors, we chose baPWV as a substitute [30,31]. In addition, urinary albumin excretion was measured from single-spot urine samples rather than 24-h urine samples in our study.…”

Parameters of pulse wave velocity: determinants and reference values assessed in the population-based study LIFE-Adult

“…In this regard, baPWV appears to be a good alternative. It can be easily obtained by wrapping blood pressure cuffs on the extremities which is more convenient for patients and more easily to apply for technical staff [ 21 , 22 ].…”

Comparison of different methods of ABI acquisition for detection of peripheral artery disease in diabetic patients

“…Our results are in good agreement with theirs. On the other hand, Massmann 15 reported excellent correlation between the use of their automated oscillometric device and ABI determined by Doppler measurement, even in the subgroup of diabetic patients. However, they used ABI HABP for the comparison and they did not report the relationship between ABI values and actual PAD presence.…”

“…For this reason, oscillometric method using automated devices has been tested in numerous studies. The correlations between oscillometric ABI, Doppler ABI and actual PAD presence determined by colour duplex sonography or by angiography however vary greatly from excellent 14,15 through good results [16][17][18] to inconclusive or poor results 13,19,20 .…”