Why the study?
Do non-invasive methods accurately estimate invasively measured aortic pulse wave velocity in patients undergoing coronary angiography?
Do non-invasive methods accurately estimate invasively measured aortic pulse wave velocity in patients undergoing coronary angiography?
Carotid-femoral PWV is the only reliable non-invasive approach to assess aortic stiffness when compared to invasive measurement.
Supports carotid-femoral PWV devices for non-invasive aortic stiffness assessment in angiography patients; leaves open outcome-linked validation in prospective cohorts.
Objective: To investigate if invasively measured aortic pulse wave velocity (PWV) is accurately estimated by non-invasive methods purporting to assess it. Methods: One-hundred and two patients (30% female, age 65 ± 13 years) planned to undertake coronary angiography were evaluated with the following non-invasive devices: BPLab (Petr Telegin, Russia), Complior Analyse (Alam Medical, France), Mobil-O-Graph (IEM, Germany), pOpmètre (Axelife, France), PulsePen-ET, PulsePen-ETT (Diatecne, Italy) and SphygmoCor (AtCor, Australia). Aortic PWV was measured by aortic catheterization and simultaneous measurement of pressure waves above the aortic valve and at the aortic bifurcation (FS-Stiffcath, Flag Vascular, Italy). Results: The devices evaluating carotid-femoral PWV showed a very strong agreement between each other (r2 > 0.65) and with invasive aortic PWV (mean difference ± SD with invasive PWV: −0.73 ± 2.83 m/s (r2 = 0.41) for Complior-Analyse; 0.20 ± 2.54 m/s (r2 = 0.51) for PulsePen-ETT; −0.04 ± 2.33 m/s (r2 = 0.61) for PulsePen-ET; −0.61 ± 2.57 m/s (r2 = 0.49) for SphygmoCor). The finger-toe PWV, evaluated by the pOpmètre, and the PWV measured by BPLab showed a weak relationship with invasive PWV (respectively r 2 =0.12, 0.05), with carotid-femoral PWV measurements (r 2 =0.11, 0.010) and with age (r 2 =0.10, 0.06). PWV estimated with Mobil-O-Graph through a proprietary algorithm showed a good agreement with invasive PWV (mean difference ± SD = −1.01 ± 2.54 m/s; r2 = 0.51) and appeared to be strictly dependent on age-squared and peripheral systolic blood pressure (r2 > 0.99). Conclusions: Methods estimating carotid-femoral PWV should be considered the only non-invasive approach to reliably assess aortic stiffness. Aortic PWV values estimated by Mobil-O-Graph algorithm are also significantly related to invasive PWV, but do not offer any additional information on top of what provided by age and systolic blood pressure levels.
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Grillo et al. (2018) studied this question.
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