Validation of a new non-invasive portable tonometer for determining arterial pressure wave and pulse wave velocity

Salvi, Paolo; Lio, Giuseppe; Labat, Carlos; Ricci, E.; Pannier, Bruno; Bénétos, Athanase

doi:10.1097/00004872-200412000-00010

Cited by 265 publications

(229 citation statements)

References 29 publications

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“…29 The applanation tonometry devices PP and SC are invasively validated. 12,27 Both use electrocardiogram-gated sequential tonometric measurements to asses aortic (carotid-femoral) PWV and are widely used in clinical and research practice. [23][24][25] Survival studies in adults indicate that PWV measured by applanation tonometry has a good clinical predictive value.…”

Section: Discussionmentioning

confidence: 99%

“…The pulse travel distance was defined as the difference between the distance from the carotid sampling site to the jugular notch and distance from the jugular notch to the femoral sampling site (Figure 1a). 27 The pulse wave was calibrated by measuring brachial blood pressure immediately before each recording. The measurement of pulse pressure was discarded and repeated if blood pressure and heart rate varied by more than 10% in the carotid and femoral sites.…”

Section: Devices Based On Applanation Tonometrymentioning

confidence: 99%

“…[22][23][24][25][26] PP and SC devices have been validated invasively in adults. 12,27 It is claimed that, in children, PWV measurements by applanation tonometry may be difficult to carry out as they are time consuming and require some degree of patient cooperation. 9 Thus, manufacturers are promoting new easy-to-use instruments to enter the market as valid tools for measuring aPWV.…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2011

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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.

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Section: Discussionmentioning

confidence: 99%

Section: Devices Based On Applanation Tonometrymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

et al. 2011

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“…We used carotidfemoral PWV and CIMT as surrogate measures for structural and functional abnormality of the arterial wall as they have shown to be valid and reproducible methods that are simple and non-invasive. 22,23 A major concern in studies that relate the biomarkers to disease is confounding by a third variable through unknown mechanisms. Consistent with previous evidence, our finding showed that most of the established cardiovascular risk factors are determinants of aortic PWV and CIMT.…”

Section: Discussionmentioning

confidence: 99%

Circulating homocysteine and large arterial stiffness and thickness in a population-based sample of middle-aged and elderly men

et al. 2007

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Elevated plasma homocysteine (tHcy) is considered as a risk factor for cardiovascular events, and has been associated with arterial stiffness and subclinical atherosclerosis in subjects with classical cardiovascular risk factors. The aim of this study is to investigate the association of plasma tHcy with functional and structural changes in the large arteries by measuring aortic pulsewave velocity (PWV) and carotid artery intima-media thickness (CIMT). In a population-based sample of 376 middle-aged and elderly men, tHcy levels were measured by using fluorescence polarization immunoassay. Aortic stiffness was assessed non-invasively by measuring carotid-femoral PWV with the use of applanation tonometry. CIMT was measured by ultrasonography. We used multivariate linear regression analysis with the logtransformed value of tHcy as the determinant, and aortic PWV and CIMT as outcomes. In the univariate model, PWV increased with increasing tHcy concentration; PWV increased by 2.64 m/s (95% confidence interval (CI) 1.74; 3.54) per unit change in log tHcy. After adjustment for confounders, no statistically significant association remained; PWV increased by 0.42 m/s (95% CI À0.27; 1.11) per unit change in log tHcy. Furthermore, in the univariate model, CIMT increased significantly with increasing tHcy concentration; CIMT increased by 0.19 mm (95% CI 0.11; 0.26) per unit increase log tHcy. This association was attenuated and did not remain significant after additional adjustment for age and cardiovascular confounders (b ¼ 0.06 (95% CI À0.01; 0.13)). The results of this study do not support the presence of an independent relationship between circulating tHcy levels and large artery stiffness and thickness.

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“…The PulsePen device has been previously described in details. [27][28] Herein, when the difference between heart rate recorded during the carotid measurement and that recorded during the femoral measurement was equal or greater than 10%, the PWV measurement was repeated (the difference in heart rate is indicated in the PulsePen software). According to this procedure, measurement of PWV had to be repeated in seven subjects.…”

Section: Reference Methodsmentioning

confidence: 99%

Comparative study of methodologies for pulse wave velocity estimation

et al. 2008

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Arterial stiffness, estimated by pulse wave velocity (PWV), is an independent predictor of cardiovascular mortality and morbidity. However, the clinical applicability of these measurements and the elaboration of reference PWV values are difficult due to differences between the various devices used. In a population of 50 subjects aged 20-84 years, we compared PWV measurements with three frequently used devices: the Complior and the PulsePen, both of which determine aortic PWV as the delay between carotid and femoral pressure wave and the PulseTrace, which estimates the Stiffness Index (SI) by analyzing photoplethysmographic waves acquired on the fingertip. PWV was measured twice by each device. Coefficient of variation of PWV was 12.3, 12.4 and 14.5% for PulsePen, Complior and PulseTrace, respectively. These measurements were compared with the reference method, that is, a simultaneous acquisition of pressure waves using two tonometers. High correlation coefficients with the reference method were observed for PulsePen (r ¼ 0.99) and Complior (r ¼ 0.83), whereas for PulseTrace correlation with the reference method was much lower (r ¼ 0.55). Upon Bland-Altman analysis, mean differences of values ± 2s.d. versus the reference method were À0.15 ± 0.62 m/s, 2.09 ± 2.68 m/s and À1.12±4.92 m/s, for PulsePen, Complior and PulseTrace, respectively. This study confirms the reliability of Complior and PulsePen devices in estimating PWV, while the SI determined by the PulseTrace device was found to be inappropriate as a surrogate of PWV. The present results indicate the urgent need for evaluation and comparison of the different devices to standardize PWV measurements and establish reference values.

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Validation of a new non-invasive portable tonometer for determining arterial pressure wave and pulse wave velocity

Abstract: These results show that the PulsePen enables an easy and reliable evaluation of central arterial pressure and stiffness in clinical ambulatory practice, especially in high-risk patients in whom arterial stiffness has been shown to be a significant indicator of morbidity and mortality.

Cited by 265 publications

References 29 publications

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

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

Circulating homocysteine and large arterial stiffness and thickness in a population-based sample of middle-aged and elderly men

Comparative study of methodologies for pulse wave velocity estimation

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