Abstract
Background: Carotid-femoral pulse wave velocity (PWV) is the gold-standard non-invasive measure of arterial stiffness. Data comparing tonometry-based devices such as the SphygmoCor XCEL to simpler brachial-cuff-based estimates of PWV, such as from the Mobil-O-Graph in African populations is sparse. We therefore aimed to compare PWV measured by the Mobil-O-Graph and the SphygmoCor XCEL device in a sample of South African women and children.
Methods: Women (n=85) 29 years (IQR:29-69) and their children/grandchildren (n=27) 7 years (IQR:4-11) were recruited for PWV measurement with Mobil-O-Graph and SphygmoCor XCEL on the same day. Wilcoxon signed-rank test, regression analysis, spearman correlation and Bland-Altman plots were used for PWV comparison between devices.
Results: For adults, the SphygmoCor XCEL device had a significantly higher PWV (7.3m/s, IQR:6.4-8.5) compared to the Mobil-O-Graph (5.9m/s,IQR:5.0-8.1,p=0.001) with a correlation coefficient of 0.809 (p=<0.001). Bland-Altman analysis indicated an acceptable level of agreement but significant bias (mean difference PWV:0.90±1.02m/s; limits of agreement:-1.10 to 2.90). The odds of having a PWV difference >1m/s decreased with a higher age (OR:0.95, 95%CI=0.92-0.98) and increased with greater height (OR:1.10,95%CI=1.01-1.21,p=0.03) in multivariable analysis. In children, the Bland-Altman indicated an excellent level of agreement (-0.03±0.63m/s; limits of agreement:-1.26 to 1.21), but no correlation was found (rs=0.08,p=0.71).
Conclusion: Particularly in younger and taller women, the Mobil-O-Graph significantly underestimated PWV compared to the SphygmoCor. While no correlation was found between the two devices for children, further research is required due to the small sample size. Furthermore, the clinical value of both methods in young African populations requires further investigation. Keywords: pulse wave analysis; vascular stiffness; cardiovascular diagnostic technique; Sub-Saharan Africa; child health; women’s health
Methods: Women (n=85) 29 years (IQR:29-69) and their children/grandchildren (n=27) 7 years (IQR:4-11) were recruited for PWV measurement with Mobil-O-Graph and SphygmoCor XCEL on the same day. Wilcoxon signed-rank test, regression analysis, spearman correlation and Bland-Altman plots were used for PWV comparison between devices.
Results: For adults, the SphygmoCor XCEL device had a significantly higher PWV (7.3m/s, IQR:6.4-8.5) compared to the Mobil-O-Graph (5.9m/s,IQR:5.0-8.1,p=0.001) with a correlation coefficient of 0.809 (p=<0.001). Bland-Altman analysis indicated an acceptable level of agreement but significant bias (mean difference PWV:0.90±1.02m/s; limits of agreement:-1.10 to 2.90). The odds of having a PWV difference >1m/s decreased with a higher age (OR:0.95, 95%CI=0.92-0.98) and increased with greater height (OR:1.10,95%CI=1.01-1.21,p=0.03) in multivariable analysis. In children, the Bland-Altman indicated an excellent level of agreement (-0.03±0.63m/s; limits of agreement:-1.26 to 1.21), but no correlation was found (rs=0.08,p=0.71).
Conclusion: Particularly in younger and taller women, the Mobil-O-Graph significantly underestimated PWV compared to the SphygmoCor. While no correlation was found between the two devices for children, further research is required due to the small sample size. Furthermore, the clinical value of both methods in young African populations requires further investigation. Keywords: pulse wave analysis; vascular stiffness; cardiovascular diagnostic technique; Sub-Saharan Africa; child health; women’s health
| Original language | English |
|---|---|
| Pages (from-to) | 65-75 |
| Journal | Journal of Hypertension |
| Volume | 40 |
| Issue number | 1 |
| Early online date | 16 Jul 2021 |
| DOIs | |
| Publication status | E-pub ahead of print - 16 Jul 2021 |
Keywords
- cardiovascular diagnostic technique
- child health
- pulse wave analysis
- sub-saharan Africa
- vascular stiffness
- women's health