Comparing oscillometric and tonometric methods to assess pulse wave velocity: a population-based study

Rosaria Del Giorno; Chiara Troiani; Sofia Gabutti; Kevyn Stefanelli; Luca Gabutti

doi:10.1080/07853890.2020.1794538

Comparing oscillometric and tonometric methods to assess pulse wave velocity: a population-based study

Ann Med. 2021 Dec;53(1):1-16. doi: 10.1080/07853890.2020.1794538. Epub 2020 Aug 13.

Authors

Rosaria Del Giorno^{1

2}, Chiara Troiani¹, Sofia Gabutti¹, Kevyn Stefanelli³, Luca Gabutti^{1

2}

Affiliations

¹ Department of Internal Medicine, Clinical Research Unit, Regional Hospital of Bellinzona and Valli, Ente Ospedaliero Cantonale, Bellinzona, Switzerland.
² Institute of Biomedicine, University of Southern Switzerland, Lugano, Switzerland.
³ Department of Social Sciences and Economics, Sapienza University of Rome, Rome, Italy.

Abstract

Background: Oscillometric pulse wave velocity (o-PWV) represents an attractive, non invasive and non operator-dependent method to estimate arterial stiffness. Tonometric carotid-femoral measurements (cf-PWV),are considered the gold-standard for non-invasive aortic stiffness assessment. To date, no studies in the general population comparing the two methods have been performed.

Methods and results: 1162 subjects were analysed. O-PWV and cf-PWV showed a mean difference of -0.31 m/sec(p ≤ 0.001). No significant differences between cf-PWV and o-PWVs were observed in patients without cardiovascular risk factors. The Bland and Altman analysis showed a moderate agreement between 24 h-o-PWV and cf-PWV (mean difference -0.99, LoA 4.23 to -6.22m/s). O-PWVs underestimate and overestimate arterial stiffness under and over 50 years respectively(p ≤ 0.001). Systolic blood pressure (SBP) and age differently impact cf-PWV and in office o-PWV variability (r² 0.35 and 0.88 respectively). In younger subjects a strong relationship between o-PWV and SBP reducing as age increases was found. Analysing the impact of age, an opposite trend was noticed.

Conclusions: Oscillometric PWV estimates provide reliable values in the general population. An o-PWV tendency to underestimate arterial stiffness in younger subjects and in subjects with diseases known to increase arterial stiffness and to overestimate it with increasing age was found, even if scarcely relevant in clinical perspective. Overall the present findings underline an acceptable and satisfactory agreement between oscillometric and tonometric methods for the PWV assessment. KEY MESSAGES Oscillometric and tonometric PWV estimates showed a good and satisfactory agreement in the general population, above all in subjects without cardiovascular risk factors or a documented vascular damage. In comparison with tonometric values, oscillometric PWV estimates showed, however, the tendency to underestimate arterial stiffness in younger subjects and to overestimate it with increasing age, while diverging when diseases known to increase arterial stiffness are present. The magnitude of differences in PWV estimates between tonometric and oscillometric methods found in the general population appears most likely not to be significant in everyday clinical practice.

Keywords: Arterial stiffness; comparative analysis; oscillometric method; pulse wave velocity; tonometric method; vascular ageing.

Publication types

Comparative Study
Research Support, Non-U.S. Gov't

MeSH terms

Adult
Age Factors
Aged
Blood Pressure / physiology
Carotid-Femoral Pulse Wave Velocity / statistics & numerical data*
Female
Heart Disease Risk Factors
Humans
Male
Manometry / statistics & numerical data*
Middle Aged
Oscillometry / statistics & numerical data*
Pulse Wave Analysis / statistics & numerical data*
Reproducibility of Results
Risk Assessment / methods*
Vascular Stiffness / physiology

Grants and funding

We gratefully acknowledge the financial support Carlo Gianella Foundation for Clinical Research (Locarno, Switzerland). The funding source had no role in study design, data collection, data analysis, data interpretation, or writing of the report.