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Validation of Central and Peripheral Non-Invasive Hemodynamic Variables Using an Oscillometric Method

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Abstract

Introduction

Peripheral and central blood pressures are parameters of arterial stiffness and important cardiovascular risk markers. Today, there are non-invasive methods that measure these pressures.

Aim

To validate the non-invasive oscillometric method, compared with invasive pressure measurements obtained by cardiac catheterization.

Methods

An open, prospective cohort clinical study in 100 patients, 64 ± 11 years old. The measurement of peripheral and central blood pressures obtained using the Arteriograph® system oscillometric method, (TensioMed, Budapest-Hungary, Ltd.) was validated in an adult population undergoing simultaneous, contralateral left cardiac catheterization (gold standard) using the radial technique, evaluating the correlation and agreement between the two methods. This study fulfils the latest standardized protocol for central blood pressure validation published by ARTERY Society.

Results

The pressures obtained with the Arteriograph® show a high correlation with the pressures measured using the gold standard. Overall, the intraclass correlation coefficient for brachial pressures was 0.80 (p < 0.001), and 0.91 (p < 0.001) for central pressures. The good agreement between the two methods was demonstrated equally by the Bland-Altman method and independent linear regressions for each variable.

Conclusions

The oscillometric noninvasive method employed is easy to use and valid for estimating hemodynamic variables such as central and peripheral arterial pressure, having good agreement and conformity with the gold standard in a different type of patients and conditions. This technique can help optimize cardiovascular assessment in primary and secondary prevention, enhance treatment in selected patients and it could be an important element for future cardiovascular prevention.

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References

  1. Laurent S, Cockcroft J, Van Bortel L, Boutouyrie P, Giannattasio C, Hayoz D, et al. Expert consensus document on arterial stiffness: methodological issues and clinical applications. Eur Heart J. 2006;27(21):2588–605.

    Article  PubMed  Google Scholar 

  2. Vlachopoulos Ch, Xaplanteris P, Aboyans V, Brodmann M, Cífkova R, Cosentino F, et al. The role of vascular biomarkers for primary and secondary prevention. A position paper from the European Society of Cardiology Working Group on peripheral circulation, Endorsed by the Association for Research into Arterial Structure and Physiology (ARTERY) Society. Atherosclerosis. 2015;241(2):507–32.

    Article  CAS  PubMed  Google Scholar 

  3. Boutouyrie P, Tropeano AI, Asmar R, Gautier I, Benetos A, Lacolley P, et al. Aortic stiffness is an independent predictor of primary coronary events in hypertensive patients: a longitudinal study. Hypertension. 2002;39(1):10–5.

    Article  CAS  PubMed  Google Scholar 

  4. Laurent S, Boutouyrie P, Asmar R, Gautier I, Laloux B, Guize L, et al. Aortic stiffness is an independent predictor of all-cause and cardiovascular mortality in hypertensive patients. Hypertension. 2001;37(5):1236–41.

    Article  CAS  PubMed  Google Scholar 

  5. Laurent S, Katsahian S, Fassot C, Tropeano AI, Gautier I, Laloux B, et al. Aortic stiffness is an independent predictor of fatal stroke in essential hypertension. Stroke. 2003;34(5):1203–6.

    Article  PubMed  Google Scholar 

  6. Cruickshank K, Riste L, Anderson SG, Wright JS, Dunn G, Gosling RG. Aortic pulse-wave velocity and its relationship to mortality in diabetes and glucose intolerance: an integrated index of vascular function? Circulation. 2002;106(16):2085–90.

    Article  PubMed  Google Scholar 

  7. Blacher J, Guerin AP, Pannier B, Marchais SJ, Safar ME, London GM. Impact of aortic stiffness on survival in end-stage renal disease. Circulation. 1999;99(18):2434–9.

    Article  CAS  PubMed  Google Scholar 

  8. Meaume S, Benetos A, Henry OF, Rudnichi A, Safar MA. Aortic pulse wave velocity predicts cardiovascular mortality in subjects > 70 years of age. Arterioscler Thromb Vasc Biol. 2001;21(12):2046–50.

    Article  CAS  PubMed  Google Scholar 

  9. Sutton-Tyrrell K, Najjar SS, Boudreau RM, Venkitachalam L, Kupelian V, Simonsick EM, et al. Elevated aortic pulse wave velocity, a marker of arterial stiffness, predicts cardiovascular events in well-functioning older adults. Circulation. 2005;111(25):3384–90.

    Article  PubMed  Google Scholar 

  10. Mattace-Raso FU, van der Cammen TJ, Hofman A, van Popele NM, Bos ML, Schalekamp MA, et al. Arterial stiffness and risk of coronary heart disease and stroke: the Rotterdam Study. Circulation. 2006;113(5):657–63.

    Article  PubMed  Google Scholar 

  11. Gasecki D, Rojek A, Kwarciany M, Kubach M, Boutouyrie P, Nyka W, et al. Aortic stiffness predicts functional outcome in patients after ischemic stroke. Stroke. 2012;43(2):543–4.

    Article  PubMed  Google Scholar 

  12. Ben-Shlomo Y, Spears M, Boustred C, May M, Anderson SG, Benjamin EJ, et al. Aortic pulse wave velocity improves cardiovascular event prediction: an individual participant meta-analysis of prospective observational data from 17,635 subjects. J Am Coll Cardiol. 2014;63(7):636–46.

    Article  PubMed  Google Scholar 

  13. Vlachopoulos C, Aznaouridis K, Stefanadis C. Prediction of cardiovascular events and all-cause mortality with arterial stiffness: a systematic review and meta-analysis. J Am Coll Cardiol. 2010;55(13):1318–27.

    Article  PubMed  Google Scholar 

  14. Sehestedt T, Jeppesen J, Hansen TW, Rasmussen S, Wachtell K, Ibsen H, et al. Risk stratification with the risk chart from the European Society of Hypertension compared with SCORE in the general population. J Hypertens. 2009;27(12):2351–7.

    Article  CAS  PubMed  Google Scholar 

  15. Mitchell GF, Hwang SJ, Vasan RS, Larson MG, Pencina MJ, Hamburg NM, et al. Arterial stiffness and cardiovascular events: the Framingham Heart Study. Circulation. 2010;121(4):505–11.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Perk J, De Backer G, Gohlke H, Graham I, Reiner Z, Verschuren WM, et al. European guidelines on cardiovascular disease prevention in clinical practice (version 2012). The Fifth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of nine societies and by invited experts). Eur Heart J. 2012;33(13):1635–701.

    Article  CAS  PubMed  Google Scholar 

  17. Mancia G, Fagard R, Narkiewicz K, Redon J, Zanchetti A, Böhm M, et al. 2013 ESH/ESC guidelines for the management of arterial hypertension: the Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Eur Heart J. 2013;34(34):2159–219.

    PubMed  Google Scholar 

  18. Ryden L, Grant PJ, Anker SD, Berne C, Cosentino F, Danchin N, et al. ESC guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD: the Task Force on diabetes, pre-diabetes, and cardiovascular diseases of the European Society of Cardiology (ESC) and developed in collaboration with the European Association for the Study of Diabetes (EASD). Eur Heart J. 2013;34(39):3035–87.

    Article  PubMed  Google Scholar 

  19. Greenland P, Alpert JS, Beller GA, Benjamin EJ, Budoff MJ, Fayad ZA, et al. 2010 ACCF/AHA guideline for assessment of cardiovascular risk in asymptomatic adults: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation. 2010;122(25):584–636.

    Article  Google Scholar 

  20. Sharman JE, Marwick TH, Gilroy D, Otahal P, Abhayaratna WP, Stowasser M, et al. Randomized trial of guiding hypertension management using central aortic blood pressure compared with best-practice care: principal findings of the BP GUIDE study. Hypertension. 2013;62(6):1138–45.

    Article  CAS  PubMed  Google Scholar 

  21. Agabiti-Rosei E, Mancia G, O’Rourke MF, Roman MJ, Safar ME, Smulyan H, et al. Central blood pressure measurements and antihypertensive therapy. A consensus document. Hypertension. 2007;50(1):154–60.

    Article  CAS  PubMed  Google Scholar 

  22. Baulmann J, Schillings U, Rickert S, Uen S, Düsing R, Illyes M, et al. A new oscillometric method for assessment of arterial stiffness: comparison with tonometric and piezo-electronic methods. J Hypertens. 2008;26(3):523–8.

    Article  CAS  PubMed  Google Scholar 

  23. Rajzer MW, Wojciechowska W, Klocek M, Palka I, Brzozowska-Kiszka M, Kawecka-Jaszcz K. Comparison of aortic pulse wave velocity measured by three techniques: complior, sphygmocor and arteriograph. J Hypertens. 2008;26(10):2001–7.

    Article  CAS  PubMed  Google Scholar 

  24. Jatoi NA, Mahmud A, Bennett K, Feely J. Assessment of arterial stiffness in hypertension: comparison of oscillometric (Arteriograph), piezoelectronic (Complior) and tonometric (SphygmoCor) techniques. J Hypertens. 2009;27(11):2186–91.

    Article  CAS  PubMed  Google Scholar 

  25. Nemcsik J, Egresits J, El Hadj Othmane T, Fekete BC, Fodor E, Szabo T, et al. Validation of arteriograph—a new oscillometric device to measure arterial stiffness in patients on maintenance hemodialysis. Kidney Blood Press Res. 2009;32(3):223–9.

    Article  PubMed  Google Scholar 

  26. Sharman JE, Avolio AP, Baulmann J, Benetos A, Blacher J, Blizzard CL, et al. Validation of non-invasive central blood pressure devices: ARTERY Society task force consensus statement on protocol standardization. Eur Heart J. 2017:1–10.

  27. Kingwell BA, Waddell TK, Medley TL, Cameron JD, Dart AM. Large artery stiffness predicts ischemic threshold in patients with coronary artery disease. J Am Coll Cardiol. 2002;40(4):773–9.

    Article  PubMed  Google Scholar 

  28. Nichols WW, Denardo SJ, Johnson BD, Sharaf BL, Bairey Merz CN, Pepine CJ. Increased wave reflection and ejection duration in women with chest pain and nonobstructive coronary artery disease: ancillary study from the Women’s ischemia Syndrome Evaluation. J Hypertens. 2013;31(7):1447–54 (discussion 1454–1455).

  29. Hashimoto J, Nichols WW, O’Rourke MF, Imai Y. Association between wasted pressure effort and left ventricular hypertrophy in hypertension: influence of arterial wave reflection. Am J Hypertens. 2008;21(3):329–33.

    Article  PubMed  Google Scholar 

  30. Hashimoto J, Imai Y, O’Rourke MF. Indices of pulse wave analysis are better predictors of left ventricular mass reduction than cuff pressure. Am J Hypertens. 2007;20(4):378–84.

    Article  PubMed  Google Scholar 

  31. Weber T, Wassertheurer S, O’Rourke MF, Haiden A, Zweiker R, Rammer M, et al. Pulsatile hemodynamics in patients with exertional dyspnea: potentially of value in the diagnostic evaluation of suspected heart failure with preserved ejection fraction. J Am Coll Cardiol. 2013;61(18):1874–83.

    Article  PubMed  Google Scholar 

  32. Holland DJ, Sacre JW, Leano RL, Marwick TH, Sharman JE. Contribution of abnormal central blood pressure to left ventricular filling pressure during exercise in patients with heart failure and preserved ejection fraction. J Hypertens. 2011;29(7):1422–30.

    Article  CAS  PubMed  Google Scholar 

  33. Horvath IG, Nemeth A, Lenkey Z, Alessandri N, Tufano F, Kis P, et al. Invasive validation of a new oscillometric device (Arteriograph) for measuring augmentation index, central blood pressure and aortic pulse wave velocity. J Hypertens. 2010;28(10):2068–75.

    Article  CAS  PubMed  Google Scholar 

  34. Liu J, Cheng HM, Chen CH, Sung SH, Hahn JO, Mukkamala R. Model-based oscillometric blood pressure measurement: preliminary validation in humans. Conf Proc IEEE Eng Med Biol Soc. 2014;2014:1961–4.

    PubMed  PubMed Central  Google Scholar 

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Acknowledgements

To all the nurses of the hemodynamics service for the work and taking care of the patients.

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Authors and Affiliations

  1. Vascular Function Research Laboratory, Interventional Cardiology Department, Fundación CardioInfantil-Instituto de Cardiología, Calle 163 A número 13B-60, Torre H. 3 Piso, Bogotá, Colombia

    Darío Echeverri, Alejandro Pizano & Jaime Cabrales

  2. Research Department, Fundación CardioInfantil-Instituto de Cardiología, Bogotá, Colombia

    Karen Moreno

Authors
  1. Darío Echeverri
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  2. Alejandro Pizano
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  4. Karen Moreno
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Corresponding author

Correspondence to Alejandro Pizano.

Ethics declarations

Good laboratory practices

This study was carried out in accordance with the Good Clinical Practice guidelines. All data obtained during the study were kept at the local study center, under an Excel data base. The data were collected, analyzed, and filed appropriately. This study was evaluated and approved by the Research Ethics Committee of the FCI-IC, and was classified as a ¨minimal risk¨ study (Chapter 1 of Resolution No. 008430 of 1993 by the Ministry of Health).

Conflict of interest

The authors express that they have no conflict of interest. This study was carried out with funds belonging to the Institution, as a research line of the Vascular Function Research Laboratory at the Fundación CardioInfantil-Instituto de Cardiología.

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Echeverri, D., Pizano, A., Cabrales, J. et al. Validation of Central and Peripheral Non-Invasive Hemodynamic Variables Using an Oscillometric Method. High Blood Press Cardiovasc Prev 25, 65–77 (2018). https://doi.org/10.1007/s40292-017-0238-8

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  • DOI: https://doi.org/10.1007/s40292-017-0238-8

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