LAUSR

Objective: Aortic pulse wave velocity (PWV) is the best indicator of aortic viscoelastic properties. Aim of this study is to investigate if invasively measured aortic PWV is accurately estimated by non-invasive methods which purport to assess it. Design and method: One-hundred and two patients (30% female, mean age 65 ± 13 years) planned to undertake a cardiac catheterization were enrolled in the study. Different non-invasive methods were evaluated for each subject by randomly alternating the following devices: BPLab, Complior Analyse, Mobil-O-Graph, pOpmètre, PulsePen-ET, PulsePen-ETT and SphygmoCor. Immediately after, aortic PWV was evaluated by aortic catheterization and simultaneous measurement of pressure wave above the aortic valve and at the aortic bifurcation (FS-Stiffcath). Invasive data were analyzed by proprietary software and compared with non-invasive PWV values by Bland-Altman analysis and paired parametric tests (for the whole population) and non-parametric tests (for quartiles of population according to PWV). Results: Devices evaluating carotid-femoral PWV (Complior Analyse, PulsePen-ET, PulsePen-ETT, SphygmoCor) and the Mobil-O-Graph presented a strong agreement with aortic invasive PWV (respectively, Pearson R = 0.64, 0.78, 0.71, 0.70, 0.66), while a moderate agreement was present for the BPLab and the pOpmètre (R = 0.23, 0.23). In the whole population, a significant underestimation of invasive PWV was present for Complior Analyse (−0.73 m/s, p = 0.016), SphygmoCor (−0.61 m/s, p = 0.024), Mobil-O-Graph (−1.01 m/s, p < 0.001) and pOpmètre (−1.55 m/s, p = 0.003). A tendency toward the overestimation of aortic PWV for lower PWV values and the underestimation of PWV for higher values was present for all devices, and was significant for the PulsePen-ET and the BPLab in the lowest quartile (PWV < 8.5 m/s, p < 0.05) and for Complior Analyse, SphygmoCor, BPLab and Mobil-O-Graph for the highest quartile (PWV > 13 m/s, p < 0.05). Conclusions: Devices measuring carotid-femoral PWV and the Mobil-O-Graph, which estimates aortic PWV from age and blood pressure values, present a good correlation with invasive aortic PWV in a large population with cardiovascular disease, while a less good agreement was found for other measuring devices (BPLab, pOpmètre). The underestimation of high PWV values may lead to erroneous estimation of cardiovascular risk by non-invasive devices.