Carotid ultrasound-based pulse wave analysis showed high correlation (r=0.95, p<0.001) and minimal mean difference (-3.48 mmHg) with standard tonometry for central aortic systolic blood pressure.
Observational (n=140)
Does carotid ultrasound-based pulse wave analysis provide comparable central hemodynamic measurements to standard applanation tonometry in adult participants?
Carotid ultrasound-based pulse wave analysis is a viable non-invasive alternative to standard applanation tonometry for assessing central hemodynamics.
Mean Difference: -3.48
p-value: p=<0.001
Objective: Accurate assessment of central hemodynamics is increasingly recognized as essential for effective cardiovascular risk stratification and management. Recent studies have demonstrated the feasibility of utilizing carotid ultrasound-based wall-tracking as an input for non-invasive pulse wave analysis (PWA). The objective of this study was to validate this novel approach by comparing it with standard applanation tonometry. Design and method: For this clinical validation, a subset of data from the CATOD study was analyzed, comprising pairwise recordings obtained through carotid ultrasound (MyLab, ESAOTE, Genoa, Italy) and carotid/radial tonometry (SphygmoCor, Atcor Medical, Syndey, Australia). Instantaneous diameter waveforms were extracted from longitudinal ultrasound scans using Carotid Studio (Quipu, Pisa, Italy) and subsequently processed with the ARCSolver algorithms (AIT, Vienna, Austria) to derive central hemodynamic parameters. The agreement between methods was evaluated using scatter plots with Pearson correlation coefficients and Bland-Altman analysis. Results: The study included 140 participants with a total of 239 pairwise recordings (mean age 58 ± 10.9 years; 148 males). Heart rate (HR) measurements obtained via tonometry and ultrasound recordings from the common carotid artery showed a strong correlation (r = 0.95, p < 0.001) with no significant bias (mean difference: 1.93 ± 4.57 bpm). Similarly, central aortic systolic blood pressure exhibited high correlation (r = 0.95, p<0.001) and minimal mean difference (-3.48 ± 4.55 mmHg), see Figure Other central aortic hemodynamic parameters also demonstrated acceptable agreement: augmentation index (r = 0.57, p<0.001; mean difference: 8.70 ± 11.54%), augmentation pressure (r = 0.72, p<0.001; mean difference: -6.00 ± 5.90 mmHg), and central pulse pressure (r = 0.92, p<0.001; mean difference: -3.41 ± 4.70 mmHg). Comparable levels of agreement were found when central aortic parameters derived from radial tonometry were compared with those obtained via carotid ultrasound.Conclusions: The application of the ARCSolver method to carotid ultrasound diameter waveforms extracted with Carotid Studio yielded central hemodynamic parameters that were in clinically acceptable agreement with those obtained via SphygmoCor-based radial and carotid tonometry. These findings support the use of carotid ultrasound-based PWA as a viable and promising alternative for non-invasive assessment of central hemodynamics in clinical practice.
Orter et al. (2026) reported an observational. Carotid ultrasound-based pulse wave analysis vs. Standard applanation tonometry was evaluated on Central aortic systolic blood pressure (r = 0.95, MD -3.48 mmHg, p=<0.001). Carotid ultrasound-based pulse wave analysis showed high correlation (r=0.95, p<0.001) and minimal mean difference (-3.48 mmHg) with standard tonometry for central aortic systolic blood pressure.
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