24-h ambulatory recording of aortic pulse wave velocity and central systolic augmentation: a feasibility study

Abstract

We assessed the feasibility of ambulatory pulse wave analysis by comparing this approach with an established tonometric technique. We investigated 35 volunteers (45.6 years; 51.0% women) exclusively at rest (R study) and 83 volunteers (49.9 years; 61.4% women) at rest and during daytime (1000-2000 h) ambulatory monitoring (R þ A study). We recorded central systolic (cSP), diastolic (cDP) and pulse (cPP) pressures, augmentation index (cAI) and pulse wave velocity (PWV) by brachial oscillometry (Mobil-O-Graph 24h PWA Monitor) and radial tonometry (SphygmoCor). We applied the Bland and Altman's statistics. In the R study, tonometric and oscillometric estimates of cSP (105.6 vs. 106.9 mm Hg), cDP (74.6 vs. 74.7 mm Hg), cPP (31.0 vs. 32.1 mm Hg), cAI (21.1 vs. 20.6%) and PWV (7.3 vs. 7.0 m s À1 ) were similar (PX0.11). In the R þ A study, tonometric vs. oscillometric assessment yielded similar values for cSP (115.4 vs. 113.9 mm Hg; P ¼ 0.19) and cAI (26.5 vs. 25.3%; P ¼ 0.54), but lower cDP (77.8 vs. 81.9 mm Hg; Po0.0001), so that cPP was higher (37.6 vs. 32.1 mm Hg; Po0.0001). PWV (7.9 vs. 7.4 m s À1 ) was higher (P ¼ 0.0002) on tonometric assessment. The differences between tonometric and oscillometric estimates increased (Pp0.004) with cSP (r ¼ 0.37), cAI (r ¼ 0.39) and PWV (r ¼ 0.39), but not (PX0.17) with cDP (r ¼ 0.15) or cPP (r ¼ 0.13). Irrespective of measurement conditions, brachial oscillometry compared with an established tonometric method provided similar estimates for cSP and systolic augmentation, but slightly underestimated PWV. Pending further validation, ambulatory assessment of central hemodynamic variables is feasible.

Body Weight Telemetry Is Useful to Reduce Interdialytic Weight Gain in Patients with End-Stage Renal Failure on Hemodialysis

“…43 In summary, all blood pressure results based on blood pressure measurement during dialysis have to be judged with caution. We believe that combination of TBWM with 24-h pulse wave analysis (PWA) via upper arm cuff of a special ABPM device, e.g., PWA monitor Mobil-O-Graph (IEM Ltd., Stolberg, Germany), 44 allows direct recording of the influence of a reduced IWG gain on augmentation index, cardiac output, and notably the 24-h blood pressure characteristics. 45 In particular, the effects of a reduced IWG on blood pressure should be examined via 24-h or 48-h blood pressure measurement in order to obtain a more exact evaluation of blood pressure characteristics 46 and to interpret possible differences in the survival rate.…”

Year in review 2016: Interstitial lung disease, pulmonary vascular disease, pulmonary function, paediatric lung disease, cystic fibrosis and sleep

“…107 Pulse wave velocity (PWV) measurement is an indirect method of estimating arterial stiffness, with recent work showing that 24-h ambulatory monitoring is feasible. 108 Using this technique in normotensive OSA patients without cardiovascular disease, Sarinc Ulasli et al 109 reported increased arterial stiffness during both daytime and night, with indices higher than in control subjects. While hypertension is highly prevalent in patients with OSA, 110 treatment with continuous positive airway pressure (CPAP) induces only modest falls in blood pressure (BP), 111 although larger falls are seen in patients with resistant hypertension or on antihypertensive drug therapy.…”

The Emergence of Ambulatory Measurement of Arterial Stiffness and Central Blood Pressure. A Promising Novelty of Clinical Importance or Just Another Marker?

“…Nevertheless, the study focused on comparing the values recorded between a tonometric and an oscillometric device and did not correlate possible diurnal changes of cBP to the established changes of peripheral BP. In addition, the ambulatory measurement of cBP did not include early morning and late night measurements, two time periods where the most important pathophysiologic alterations in peripheral BP take place [55].…”