Clinical Validation of Carotid-Femoral Pulse Wave Velocity Measurement Using a Multi-Beam Laser Vibrometer: The CARDIS Study.

IF 6.9 1区医学 Q1 PERIPHERAL VASCULAR DISEASE Hypertension Pub Date : 2024-09-01 Epub Date: 2024-06-27 DOI:10.1161/HYPERTENSIONAHA.124.22729

Smriti Badhwar, Louise Marais, Hakim Khettab, Federica Poli, Yanlu Li, Patrick Segers, Soren Aasmul, Mirko de Melis, Roel Baets, Steve Greenwald, Rosa Maria Bruno, Pierre Boutouyrie

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Abstract

Background: Carotid-femoral pulse wave velocity (cfPWV) is the gold standard for noninvasive arterial stiffness assessment, an independent predictor of cardiovascular disease, and a potential parameter to guide therapy. However, cfPWV is not routinely measured in clinical practice due to the unavailability of a low-cost, operator-friendly, and independent device. The current study validated a novel laser Doppler vibrometry (LDV)-based measurement of cfPWV against the reference technique.

Methods: In 100 (50 men) hypertensive patients, cfPWV was measured using applanation tonometry (Sphygmocor) and the novel LDV device. This device has 2 handpieces with 6 laser beams each that simultaneously measure vibrations from the skin surface at carotid and femoral sites. Pulse wave velocity is calculated using ECG for the identification of cardiac cycles. An ECG-independent method was also devised. Cardiovascular risk score was calculated for patients between 40 and 75 years old using the WHO risk scoring chart.

Results: LDV-based cfPWV correlated significantly with tonometry (r=0.86, P<0.0001 ECG-dependent [cfPWV_{LDV_ECG}] and r=0.80, P<0.001 ECG-independent [cfPWV_{LDV_w/oECG}] methods). Bland-Altman analysis showed nonsignificant bias (0.65 m/s) and acceptable SD (1.27 m/s) between methods. Intraobserver coefficient of variance for LDV was 4.7% (95% CI, 3.0%-5.5%), and interobserver coefficient of variance was 5.87%. CfPWV correlated significantly with CVD risk (r=0.64, P<0.001; r=0.41, P=0.003; and r=0.37, P=0.006 for tonometry, LDV-with, and LDV-without ECG, respectively).

Conclusions: The study demonstrates clinical validity of the LDV device. The LDV provides a simple, noninvasive, operator-independent method to measure cfPWV for assessing arterial stiffness, comparable to the standard existing techniques.

Registration: URL: https://clinicaltrials.gov/study/NCT03446430; Unique identifier: NCT03446430.

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使用多束激光测振仪测量颈动脉-股动脉脉搏波速度的临床验证：CARDIS研究

背景：颈动脉-股动脉脉搏波速度（cfPWV颈动脉-股动脉脉搏波速度（cfPWV）是无创动脉僵化评估的黄金标准，是心血管疾病的独立预测指标，也是指导治疗的潜在参数。然而，由于缺乏低成本、操作简便且独立的设备，cfPWV 并未在临床实践中得到常规测量。本研究将基于激光多普勒测振仪（LDV）的新型 cfPWV 测量方法与参考技术进行了验证：方法：在 100 名（50 名男性）高血压患者中，使用眼压计（Sphygmocor）和新型 LDV 设备测量 cfPWV。该设备有两个手机，每个手机有 6 束激光，可同时测量颈动脉和股动脉部位皮肤表面的振动。利用心电图计算脉搏波速度，以识别心动周期。此外，还设计了一种与心电图无关的方法。使用世界卫生组织风险评分表为 40 至 75 岁的患者计算心血管风险评分：结果：基于 LDV 的 cfPWV 与眼压测量法有显著相关性（PLDV_ECG] 方法的相关性为 0.86，PLDV_w/oECG] 方法的相关性为 0.80）。Bland-Altman分析显示，不同方法之间的偏差（0.65 m/s）不明显，SD（1.27 m/s）可接受。LDV 的观察者内方差系数为 4.7%（95% CI，3.0%-5.5%），观察者间方差系数为 5.87%。CfPWV与心血管疾病风险有显著相关性（眼压测量、带心电图的LDV和不带心电图的LDV分别为r=0.64，PP=0.003；和r=0.37，P=0.006）：该研究证明了 LDV 设备的临床有效性。LDV为评估动脉僵化提供了一种简单、无创、独立于操作者的cfPWV测量方法，可与现有的标准技术相媲美：URL: https://www.clinicaltrials.gov; 唯一标识符：NCT03446430。

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来源期刊

Hypertension 医学-外周血管病

CiteScore

15.90

自引率

4.80%

发文量

1006

审稿时长

1 months

期刊介绍： Hypertension presents top-tier articles on high blood pressure in each monthly release. These articles delve into basic science, clinical treatment, and prevention of hypertension and associated cardiovascular, metabolic, and renal conditions. Renowned for their lasting significance, these papers contribute to advancing our understanding and management of hypertension-related issues.