Repeatability of Central and Peripheral Pulse Wave Velocity Measures: The Atherosclerosis Risk in Communities (ARIC) Study
Repeatability of Central and Peripheral Pulse Wave Velocity Measures: The Atherosclerosis Risk in Communities (ARIC) Study
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DOI：
10.1093/ajh/hpv127
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发表时间：
2016-04-01
影响因子：
3.2
通讯作者：
Heiss, Gerardo
中科院分区：
文献类型：
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作者：
Meyer, Michelle L.;Tanaka, Hirofumi;Heiss, Gerardo
背景动脉僵硬测量是高血压和心血管疾病(CVD)风险评估和分层的新兴工具。颈动脉-股动脉脉搏波速度(CfPWV)是一种公认的中央动脉僵硬的测量方法。其他测量PWV的指标包括股踝(FaPWV)和臂踝PWV(BaPWV)，前者是外周硬度的量度，后者是中枢和外周硬度的综合量度。中心、外周和复合PWV测量的可重复性还没有得到充分的检查或比较。方法来自社区动脉粥样硬化风险(ARIC)研究访问5(2011-2013)中嵌套的可重复性研究的参与者(n=79；平均年龄75.7岁；美国)接受了2次标准化访问，间隔4-8周。训练有素的技术人员每次使用VP-1000 Plus系统进行2次PWV测量。结果cfPWV组内相关系数和95%可信区间为0.70(0.59，0.81)，baPWV为0.84(0.78，0.90)，faPWV为0.69(0.59，0.79)。个体内重复测量的MDC95分别为411.0 cm/S、370.6 cm/S和301.4 cm/S。每组100个独立样本的MDDcfPWV为139.3 cm/S，BaPWV为172.3 cm/S，faPWV为100.4 cm/S。结论在一项以人群为基础的多中心老年人研究中，所有PWV测量的重复性均可接受，并支持其在流行病学研究中的应用。量化PWV测量差异对于风险评估和分层的应用以及最终转化为临床实践至关重要。
BACKGROUNDArterial stiffness measures are emerging tools for risk assessment and stratification for hypertension and cardiovascular disease (CVD). Carotid-femoral pulse wave velocity (cfPWV) is an established measure of central arterial stiffness. Other measures of PWV include femoral-ankle (faPWV), a measure of peripheral stiffness, and brachial-ankle PWV (baPWV), a composite measure of central and peripheral stiffness. Repeatability of central, peripheral, and composite PWV measures has not been adequately examined or compared.METHODSParticipants (n = 79; mean age 75.7 years; USA) from a repeatability study nested within the Atherosclerosis Risk in Communities (ARIC) Study visit 5 (2011-2013) underwent 2 standardized visits, 4-8 weeks apart. Trained technicians obtained 2 PWV measurements at each visit using the VP-1000 Plus system. We calculated the intraclass correlation coefficient (ICC), SE of measurement, and minimal detectable change (MDC95; 95% confidence interval) and difference (MDD).RESULTSThe ICCs and 95% confidence intervals (95% CIs) were 0.70 (0.59, 0.81) for cfPWV, 0.84 (0.78, 0.90) for baPWV, and 0.69 (0.59, 0.79) for faPWV. The MDC95 between repeat measures within an individual was 411.0cm/s for cfPWV, 370.6cm/s for baPWV, and 301.4cm/s for faPWV. The MDD for 2 independent samples of 100 per group was 139.3cm/s for cfPWV, 172.3cm/s for baPWV, and 100.4cm/s for faPWV.CONCLUSIONSRepeatability was acceptable for all PWV measures in a multicenter, population-based study of older adults and supports its use in epidemiologic studies. Quantifying PWV measurement variation is critical for applications to risk assessment and stratification and eventual translation to clinical practice.