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Comparative Study
. 2014 Jul;32(7):1464-9; discussion 1469.
doi: 10.1097/HJH.0000000000000203.

Measurement of pulse wave velocity in children: comparison of volumetric and tonometric sensors, brachial-femoral and carotid-femoral pathways

Louise Keehn  1 , Laura Milne, Karen McNeill, Phil Chowienczyk, Manish D Sinha
Affiliations
Free PMC article
Comparative Study

Measurement of pulse wave velocity in children: comparison of volumetric and tonometric sensors, brachial-femoral and carotid-femoral pathways

Louise Keehn et al. J Hypertens. 2014 Jul.
Free PMC article

Abstract

Background: Pulse wave velocity (PWV), a measure of arterial stiffness strongly predictive of cardiovascular risk in adults, is usually measured by sequential ECG-referenced carotid and femoral tonometry. A simplified technique, more suitable for use in children, employs simultaneous volumetric recording from a sensor applied over the carotid artery and a cuff applied over the femoral artery or arm and thigh pressure cuffs applied over the brachial and femoral arteries. The purpose of this study was to compare PWV computed over the carotid-femoral path (PWVcf) with that over the brachial-femoral path (PWVbf) using a volumetric system (Vicorder) and to compare values of PWVcf obtained by the volumetric and a tonometric method (SphygmoCor) in children.

Method: Vicorder PWVcf and PWVbf were compared in 156 children (3-18 years, 110 with chronic kidney disease), and PWVcf by Vicorder was compared to PWVcf by SphygmoCor in a subset of 122 patients.

Results: PWVcf by Vicorder was moderately correlated with PWVcf by SphygmoCor (R = 0.50, P < 0.000). PWVbf and PWVcf Vicorder were more closely correlated (R = 0.75, P < 0.0001), but with a significant systematic difference. Applying a correction factor to PWVbf measurements gave results similar to those obtained over the carotid-femoral path. Within-patient coefficients of variation for repeated measures were 5.9, 7.8, and 8.5% for PWVbf (Vicorder), PWVcf (Vicorder) and PWVcf (SphygmoCor), respectively. All PWV values showed a similar relation to age.

Conclusion: Volumetric methods appear reproducible and are easy to use in children, but values obtained by Vicorder and SphygmoCor are not interchangeable even when measured over the same pathway.

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Figures

FIGURE 1
FIGURE 1
(a) Correlation between Vicorder PWVcf and PWVbf, (b) Bland-Altman plot of agreement between Vicorder PWVcf and Vicorder PWVbf, (c) Bland-Altman plot of agreement between Vicorder PWVcf and corrected PWVbf. PWVbf, brachial-femoral pulse wave velocity; PWVcf, carotid-femoral pulse wave velocity.
FIGURE 2
FIGURE 2
(a) Correlation between SphygmoCor PWVcf and Vicorder PWVcf, (b) Bland-Altman plot of agreement between SphygmoCor PWVcf and Vicorder PWVcf. PWVbf, brachial-femoral pulse wave velocity; PWVcf, carotid-femoral pulse wave velocity.
FIGURE 3
FIGURE 3
(a) Correlation between SphygmoCor PWVcf and corrected Vicorder PWVbf, (b) Bland-Altman plot of agreement between SphygmoCor PWVcf and corrected Vicorder PWVbf. PWVbf, brachial-femoral pulse wave velocity; PWVcf, carotid-femoral pulse wave velocity.
FIGURE 4
FIGURE 4
Variation of mean PWV according to age, as calculated by each device. PWV, pulse wave velocity.
FIGURE 5
FIGURE 5
ROC curve showing area under the curve for each method of PWV measurement. PWV, pulse wave velocity; ROC, receiver-operating characteristic curve.
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