Intrarater Reliability and Agreement of Blood Pressure, Arterial Stiffness, and Heart Rate Variability Assessments in Patients With Parkinson's Disease.

Verônica de Fátima Souza Lima, Rafael Yokoyama Fecchio, Maria Elisa Pimentel Piemonte, Marilia de Almeida Correia, Hélcio Kanegusuku, Raphael Mendes Ritti-Dias
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Abstract

To assess the intrarater reliability and agreement of blood pressure (BP), arterial stiffness, and heart rate variability (HRV) assessments in patients with Parkinson`s disease (PD). Twenty patients with PD visited the laboratory three times, during which brachial and central BP (auscultatory and applanation tonometry, respectively), arterial stiffness (carotid-femoral pulse wave velocity and augmentation index), and HRV assessments were performed at rest. Brachial and central systolic BP presented greater values on visit 1 when compared to visits 2 and 3 (122±13 vs. 116±16 vs. 120±15, p=0.029). There were no significant differences (p>0.05) among the experimental visits for other parameters. Brachial and central BP showed an intraclass correlation coefficient (ICC) above 0.842 and a standard error of measurement (SEM) lower than 5.0%. Bland-Altman plots indicated low agreement between visits 1 and 2 and good agreement between visits 2 and 3. Arterial stiffness indices exhibited ICC values between 0.781 and 0.886, and SEM ranged from 7.3% to 25.2%. Bland-Altman plots indicated moderate to good agreement among visits for arterial stiffness parameters. HRV indices presented ICC values ranging from 0.558 to 0.854 and SEM values ranging from 5.1% to 76.0%. Bland-Altman plots indicated moderate agreement among visits for HRV parameters. In PD patients, brachial and central BP present low intrarater reliability and agreement between visits 1 and 2 and good intrarater reliability and agreement between visits 2 and 3. In general, arterial stiffness and HRV assessments present acceptable intrarater reliability and agreement among visits, except for cardiac sympathovagal balance.

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帕金森病患者血压、动脉僵硬度和心率变异性评估的内部可靠性和一致性。
目的:评估帕金森病(PD)患者血压(BP)、动脉僵化和心率变异性(HRV)评估的内部可靠性和一致性。20 名帕金森病患者到实验室就诊 3 次,期间在休息状态下进行了肱动脉和中心血压(分别为听诊法和眼压计法)、动脉僵化(颈动脉-股动脉脉搏波速度和增强指数)和心率变异性评估。与第 2 次和第 3 次测试相比,第 1 次测试的肱动脉收缩压和中心收缩压数值更大(122±13 对 116±16 对 120±15,P=0.029)。其他参数在各实验观察点之间无明显差异(P>0.05)。肱动脉血压和中心血压的类内相关系数 (ICC) 高于 0.842,测量标准误差 (SEM) 小于 5.0%。Bland-Altman 图显示,第 1 次和第 2 次之间的一致性较低,而第 2 次和第 3 次之间的一致性较好。动脉僵化指数的 ICC 值介于 0.781 和 0.886 之间,SEM 介于 7.3% 和 25.2% 之间。Bland-Altman图显示,动脉僵化参数在各次检查中的一致性为中等至良好。心率变异指数的 ICC 值介于 0.558 和 0.854 之间,SEM 值介于 5.1% 和 76.0% 之间。Bland-Altman图显示,心率变异参数在各就诊点之间的一致性适中。在帕金森氏症患者中,肱动脉血压和中心血压在第 1 次和第 2 次就诊之间的校内可靠性和一致性较低,而在第 2 次和第 3 次就诊之间的校内可靠性和一致性较好。总体而言,动脉僵化和心率变异评估在各就诊点之间具有可接受的内部可靠性和一致性,但心脏交感-摆动平衡除外。
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