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Validation of a cuff-based device for measuring carotid-femoral pulse wave velocity in children and adolescents

Journal of Human Hypertension volume 34, pages 311–318 (2020)Cite this article

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Abstract

Carotid-femoral pulse wave velocity is associated with arterial stiffness in major elastic arteries, and predicts future cardiovascular events. However, little is known about carotid-femoral pulse wave velocity as a marker of vascular health in children. Semi-automated cuff-based devices for assessing pulse wave velocity are increasingly popular, although these utilize an algorithm developed and validated in adults. Physiological differences between adults and children may, however, reduce the accuracy of cuff-based methods. We sought to determine the accuracy of a cuff-based pulse wave velocity device in healthy children, and determine whether a novel age-appropriate algorithm increases accuracy. We recruited 29 healthy children between the ages of 2 and 20 years. Pulse wave velocity was measured both by using a tonometer on the carotid artery and an inflated cuff on the thigh, and using a tonometer on both the carotid artery and femoral artery as a reference standard. Accuracy of the cuff-based device with its standard algorithm developed in adults, and a novel age-appropriate algorithm corrected for physiological differences in leg pulse wave velocity was assessed with Regression analysis and Bland-Altman plots. Cuff-based device estimates of pulse wave velocity had excellent agreement to the reference standard (Δ = −0.26 ms−1 [SD 0.44]). The novel age-appropriate algorithm improved the accuracy of the cuff-based method (Δ = 0.02 ms−1 [SD 0.44]). The cuff-based semi-automatic approach estimates carotid-femoral pulse wave velocity with excellent agreement to the reference standard. However, adjusting the algorithm for known differences in leg pulse wave velocity further improves the accuracy of cuff-based measurement in children and adolescents.

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Acknowledgements

This work was supported by a NSW CVRN Research Development Project Grant (#101135) from the National Heart Foundation of Australia;. MRS is supported by a Future Leader fellowship from the National Heart Foundation of Australia (#100419). Equipment was provided by AtCor Medical for use during this project.

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Authors and Affiliations

  1. School of Medicine, University of Sydney, Sydney, NSW, Australia

    Tommy Y. Cai, Alice Meroni, Hasthi Dissanayake, Melinda Phang, David S. Celermajer & Michael R. Skilton

  2. Boden Institute of Obesity, Nutrition, Exercise, and Eating Disorders, University of Sydney, Sydney, NSW, Australia

    Tommy Y. Cai, Alice Meroni, Hasthi Dissanayake, Melinda Phang & Michael R. Skilton

  3. Charles Perkins Centre, University of Sydney, Sydney, NSW, Australia

    Tommy Y. Cai, Alice Meroni, Hasthi Dissanayake, Melinda Phang & Michael R. Skilton

  4. Australian School of Advanced Medicine, Macquarie University, Sydney, NSW, Australia

    Alberto Avolio, Mark Butlin & Ahmad Qasem

  5. Department of Cardiology, Royal Prince Alfred Hospital, Sydney, NSW, Australia

    David S. Celermajer

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  1. Tommy Y. Cai
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Correspondence to Michael R. Skilton.

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Dr Ahmed Qasem is an employee of AtCor Medical. The other authors declare that they have no conflict of interest.

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Cai, T.Y., Meroni, A., Dissanayake, H. et al. Validation of a cuff-based device for measuring carotid-femoral pulse wave velocity in children and adolescents. J Hum Hypertens 34, 311–318 (2020). https://doi.org/10.1038/s41371-019-0191-1

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