دانلود رایگان مقاله برآورد سفتی شریان و فشار خون میانی در بیماران مبتلا به دیابت نوع 2

Abstract

Background: The Arteriograph is a cuff-based oscillometric device for non-invasive assessment of central systolic blood pressure (cSBP), aortic augmentation index (Aix) and aortic pulse wave velocity (PWV). Reproducibility of Arteriograph measurements and the agreement with SphygmoCor in diabetic patients has never been assessed. Methods: We compared Arteriograph reproducibility and agreement with SphygmoCor with data from two study populations: Study 1 (n Z 17) was conducted in a research laboratory and Study 2 (n Z 19) in a catheter lab. SphygmoCor PWV data was only available in study 1. Results: Reproducibility: Mean differences (
Standard deviation of the difference (SDD)) between duplicate cSBP, Aix and PWV Arteriograph measurements were 0.6
6.6 mmHg, 1.1
3.3% and 0.1
0.5 m/s in study 1 and 0.01
4.3 mmHg, 1.5
3.2% and 0.2
0.6 m/s in study 2, all differences non-significant. Agreement: Mean differences between SphygmoCor and Arteriograph were 14
10 mmHg, 8
7% and 2.4
1.8 m/s, (p < 0.001 for all) in Study 1 and 5
10 mmHg, p Z 0.04 and 10
8%, p Z <0.001 in Study 2. In study 1, a significant correlation was observed between the mean and the difference for cSBP, r Z 0.75, p < 0.001 and for Aix, r Z 0.67, p < 0.001. Conclusions: In type 2 diabetics, Arteriograph data were reproducible yet systematically overestimated cSBP, Aix and PWV compared with SphygmoCor. Hence, the two devices cannot be used interchangeably in type 2 diabetics. ª 2016

Discussion

PWV, central BP and Aix are receiving increasing attention as potential novel markers of cardiovascular events. Several devices for non-invasive measurements have been marketed. In this study we assessed the reproducibility of the Arteriograph device and the agreement with the SphygmoCor in two diabetic populations. The overall finding in this study was a good reproducibility of measurements using the Arteriograph. However, we found significant differences between Arteriograph and SphygmoCor. In Study 1, the Arteriograph gave higher estimates of cSBP and Aix than the SphygmoCor. Furthermore, the difference between the two devices increased at higher values of cSBP and Aix. Similarly, the Arteriograph gave systematically lower estimates of PWV compared to the SphygmoCor. In Study 2, a systematic difference between the two devices was also observed. In this study, no trend towards greater differences at higher values was observed for cSBP and Aix. A number of studies comparing Arteriograph and SphygmoCor have been conducted. A study in hypertensive patients8 showed good correlation between measurements obtained by Arteriograph and SphygmoCor, but poor agreement and wide limits of agreement. In a study on healthy individuals,11 the Arteriograph recorded higher values of cSBP as compared to the SphygmoCor. A close correlation was observed between Aix values obtained by Arteriograph and SphygmoCor, but the Arteriograph systematically recorded higher Aix values.