Measurement of pulse wave velocity in children and young adults: a comparative study using three different devices

Abstract

To estimate the value of pulse wave velocity (PWV) in pediatric cardiovascular disease, prospective studies are needed. Various instruments based on different measurement principles are proposed for use in children, hence the need to test the comparability of these devices in this younger population. The objective of this study was to compare PWV measured by oscillometry (Vicorder (VIC)) with the gold standard of applanation tonometry (PulsePen (PP), Sphygmocor (SC)). PWV was measured in 98 children and young adults (age: 16.7(6.3-26.6) years (median(range)) with the above three devices at the same visit under standardized conditions. Mean PWV measured by VIC was significantly lower than that measured by SC and PP. There was no difference following path length correction of the VIC measurement (using the distance between the jugular notch and the center of the femoral cuff), (PP: 6.12(1.00), SC: 5.94(0.91), VIC: 6.14(0.75) m s À1 ). Velocities measured by the three devices showed highly significant correlations. Bland-Altman analysis revealed excellent concordance between all three devices, however, there was a small but significant proportional error in the VIC measurements showing a trend toward lower PWV measured by VIC at higher PWV values. Our study provides data on the three most frequently used instruments in pediatrics. Following path length correction of the VIC, all three devices provided comparable results. Thus, our work allows extrapolating data between previously established normal PWV values for children and forthcoming studies using these instruments to assess children at long-term risk of cardiovascular disease. The small proportional error of VIC needs additional technical development to improve the accuracy of the measurements.

The Vicorder device compared with SphygmoCor in the assessment of carotid–femoral pulse wave velocity in patients with peripheral arterial disease

“…13,14 However, this is the first study in the literature to compare between the two device's cfPWV values in patients with PAD. The difference between healthy subjects and patients with PAD is that the latter have higher values of cfPWV owing to increased arterial stiffness caused by atherosclerosis.…”

“…The reproducibility of the Vicorder has been assessed in comparison with the more established SphygmoCor system in healthy subjects 9,12 and in children. 13,14 However, to date, there are no studies in the literature comparing between the two devices in the context of peripheral arterial disease (PAD). Patients with PAD have increased arterial stiffness and difficult-to-palpate peripheral pulses.…”

Why are kids with lupus at an increased risk of cardiovascular disease?

“…Patients with CV events have been shown in retrospective reviews to have higher disease scores such as SLE Disease Activity Index (SLEDAI) [119][120][121][122][123], and higher Systemic Lupus International Collaborative Clinics (SLICC) scores have been correlated with pre-clinical CV abnormalities, [124,125] such as aortic calcification [76,[126][127][128][129][130][131][132]. Higher SLEDAI scores have also been correlated with lower values for left ventricular longitudinal function measured by strain rate and strain imaging [126].…”

Arterial Stiffness in Children: Pediatric Measurement and Considerations

“…In adults, the ‘gold standard' for the noninvasive assessment of arterial stiffness is carotid-femoral PWV (cfPWV) [5]. While other methods of assessing aortic PWV have been validated, and largely show comparable results [7,8,9], in this paper, we will primarily focus on cfPWV as measured by applanation tonometry, unless otherwise specified.…”