Abstract
Background:Carotid-femoral pulse wave velocity (PWV) is the gold-standard noninvasive measure of arterial stiffness. Data comparing tonometry-based devices such as the SphygmoCor XCEL to simpler brachial-cuff-based estimates of PWV, such as from the Mobil-O-Graph in African populations are sparse. We therefore aimed to compare PWV measured by the Mobil-O-Graph and the SphygmoCor XCEL device in a sample of South African women and children.Methods:Women (n = 85) 29 years [interquartile range (IQR): 29–69] and their children/grandchildren (n = 27) 7 years (IQR: 4–11) were recruited for PWV measurement with Mobil-O-Graph and SphygmoCor XCEL on the same day. Wilcoxon signed-rank test, regression analysis, spearman correlation and Bland–Altman plots were used for PWV comparison between devices.Results:For adults, the SphygmoCor XCEL device had a significantly higher PWV (7.3 m/s, IQR: 6.4–8.5) compared with the Mobil-O-Graph (5.9 m/s, IQR: 5.0–8.1, P = 0.001) with a correlation coefficient of 0.809 (P ≤ 0.001). Bland--Altman analysis indicated an acceptable level of agreement but significant bias (mean difference PWV: 0.90 ± 1.02 m/s; limits of agreement: −1.10 to 2.90). The odds of having a PWV difference more than 1 m/s decreased with a higher age [odds ratio (OR): 0.95, 95% confidence interval (95% CI) = 0.92–0.98] and increased with greater height (OR: 1.10, 95% CI = 1.01–1.21, P = 0.03) in multivariable analysis. In children, the Bland–Altman indicated an excellent level of agreement (−0.03 ± 0.63 m/s; limits of agreement: −1.26 to 1.21), but no correlation was found (rs = 0.08, P = 0.71).Conclusion:Particularly in younger and taller women, the Mobil-O-Graph significantly underestimated PWV compared with the SphygmoCor. Although no correlation was found between the two devices for children, further research is required due to the small sample size. Furthermore, the clinical value of both methods in young African populations requires further investigation.
Highlights
Cardiovascular disease (CVD) is one of the global leading causes of death and disability [1,2,3]
The aim of our study was to compare pulse wave velocity (PWV) measured by both the Mobil-O-Graph and the SphygmoCor XCEL device in a lower-middle-income countries (LMIC) population in South Africa in both women and children
Considering that there was a poor correlation between PWV measurement and that our sample size was small (n 1⁄4 27), conclusions regarding the validity of PWV by the Mobil-O-Graph in children need to be confirmed in future studies with larger sample sizes
Summary
Cardiovascular disease (CVD) is one of the global leading causes of death and disability [1,2,3]. Carotid–femoral pulse wave velocity (cf-PWV) is considered the gold standard for noninvasive measurement of arterial stiffness, predominantly used in research settings [17,18], and the SphygmoCor Cardiovascular Management System (CvMS) system (AtCor Medical, Sydney, New South Wales, Australia) is well validated and widely used for cf-PWV measurement [13,19]. A new SphygmoCor device (SphygmoCor XCEL; AtCor Medical), which measures cf-PWV using a partially inflated femoral cuff simultaneously with carotid applanation tonometry, has been developed and validated against the earlier SphygmoCor CvMS device [20], and is widely used in a research context despite a lack of clinical validation studies for the XCEL device [21,22]. We aimed to compare PWV measured by the Mobil-O-Graph and the SphygmoCor XCEL device in a sample of South African women and children
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