Monday, May 26, 2014

Arterial Stiffness

Validation of Arteriograph – A New Oscillometric Device to Measure Arterial Stiffness in Patients on Maintenance Hemodialysis Nemcsik J. • Egresits J. • El Hadj Othmane T. • Fekete B.C. • Fodor E. • Szabó T. • Járai Z. • Jekkel C. • Kiss I. • Tislér A. Kidney Blood Press Res 2009;32:223–229 (DOI: 10.1159/000228935) Abstract Background: Measuring arterial stiffness (augmentation index (AI), aortic pulse wave velocity (PWV)) in hemodialysis (HD) patients has prognostic significance. To assess its validity, the new oscillometric Arteriograph device (AIA, PWVA) was compared to the validated PulsePen tonometer (AIP, PWVP). Methods: AI and PWV were measured in 98 patients with both devices before HD. Validity was evaluated by Pearson’s correlation, Bland-Altman analysis, and by assessing the prognostic value of AI and PWV to predict cardiovascular (CV) mortality over 29 months. Results: Correlation between AIP and AIA was significant (R = 0.527, p < 0.001). The mean difference of AI values obtained by the two devices was –20.6%, and 30% of the paired AI differences fall outside the ±1 SD boundary of the mean between-device difference. There was no significant correlation between the PWVP and PWVA readings (R = 0.173, p = 0.097). The average difference of PWV values by the two devices was –1.2 m/s, and 20.6% of the paired PWV differences fall outside the ±1 SD boundary. In survival analyses, only PWVP but not PWVA was significantly related to CV mortality. Conclusion: Lack of correlation between PWVP and PWVA and lack of prognostic significance of PWVA suggest limited validity of Arteriograph to determine PWV in patients on HD.

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