Cora McGreevy1, Miriam Barry1, Kathleen Bennett2, David Williams1. 1. a Department of Geriatric and Stroke Medicine, Royal College of Surgeons in Ireland (RCSI), Beaumont Hospital , Dublin. 2. b Department of Pharmacology and Therapeutics, Trinity Centre for Health Sciences, St James's Hospital , Dublin, Ireland.
Abstract
BACKGROUND: Pulse wave velocity measured using the Vicorder(®) apparatus is a non-invasive indicator of arterial stiffness. The objective of this study was to assess its repeatability in older patients when used by medical professionals with limited experience of the technique. METHODS: Aortic pulse wave velocity (aPWV) was measured using the Vicorder(®) system four times using the conventional pathway and twice by adapted pathway in 25 consecutive ambulant patients (15 male) after they rested supine for 15 min. A nurse and a doctor independently and alternately measured PWV using the same equipment and were blinded to their colleague's PWV readings. 'Within' and 'between' observer differences were assessed using intra-class correlation coefficients (rI) and 95% limits of agreement (95% LoA) derived from Bland-Altman plots. RESULTS: Mean age was 79.8 (mean blood pressure [BP] = 133/69, Mean heart rate [HR]: 70.9). Mean PWV was 11.73 (Standard Deviation [SD] 2.6-3.6). 'Between' and 'within' observer repeatability was high, with rIs ranging from 0.8-0.93. The repeatability index for 'between' nurse and doctor measures was slightly lower (rI = 0.88) when an adapted cuff measure was used in assessing PWV compared to conventional cuff measures (rI = 0.93). Mean PWV readings 'between' observers differed by only 0.094 (95% CI -0.24 to 1.59). CONCLUSION: When undertaken by operators with limited previous technical experience, both 'within' and 'between' observer repeatability of PWV measurement was high. This method has the potential to be included in the clinical assessment of arterial stiffness in older ambulant patients.
BACKGROUND: Pulse wave velocity measured using the Vicorder(®) apparatus is a non-invasive indicator of arterial stiffness. The objective of this study was to assess its repeatability in older patients when used by medical professionals with limited experience of the technique. METHODS: Aortic pulse wave velocity (aPWV) was measured using the Vicorder(®) system four times using the conventional pathway and twice by adapted pathway in 25 consecutive ambulant patients (15 male) after they rested supine for 15 min. A nurse and a doctor independently and alternately measured PWV using the same equipment and were blinded to their colleague's PWV readings. 'Within' and 'between' observer differences were assessed using intra-class correlation coefficients (rI) and 95% limits of agreement (95% LoA) derived from Bland-Altman plots. RESULTS: Mean age was 79.8 (mean blood pressure [BP] = 133/69, Mean heart rate [HR]: 70.9). Mean PWV was 11.73 (Standard Deviation [SD] 2.6-3.6). 'Between' and 'within' observer repeatability was high, with rIs ranging from 0.8-0.93. The repeatability index for 'between' nurse and doctor measures was slightly lower (rI = 0.88) when an adapted cuff measure was used in assessing PWV compared to conventional cuff measures (rI = 0.93). Mean PWV readings 'between' observers differed by only 0.094 (95% CI -0.24 to 1.59). CONCLUSION: When undertaken by operators with limited previous technical experience, both 'within' and 'between' observer repeatability of PWV measurement was high. This method has the potential to be included in the clinical assessment of arterial stiffness in older ambulant patients.
Authors: Jehill D Parikh; Kieren G Hollingsworth; Vijay Kunadian; Andrew Blamire; Guy A MacGowan Journal: BMC Cardiovasc Disord Date: 2016-02-19 Impact factor: 2.298
Authors: Britt Hofmann; Marcus Riemer; Christian Erbs; Alexander Plehn; Alexander Navarrete Santos; Andreas Wienke; Rolf-Edgar Silber; Andreas Simm Journal: J Clin Hypertens (Greenwich) Date: 2014-08-01 Impact factor: 3.738
Authors: Jehill D Parikh; Kieren G Hollingsworth; Dorothy Wallace; Andrew M Blamire; Guy A MacGowan Journal: Int J Cardiol Date: 2016-07-30 Impact factor: 4.164