Validation of arteriograph - a new oscillometric device to measure arterial stiffness in patients on maintenance hemodialysis

Abstract

Background: Measuring arterial stiffness (augmentation index (AI), aortic pulse wave velocity (PWV)) in hemodialysis (HD) patients has prognostic significance. To assess its validity, the new oscillometric Arteriograph device (AI(A), PWV(A)) was compared to the validated PulsePen tonometer (AI(P), PWV(P)).

Methods: AI and PWV were measured in 98 patients with both devices before HD. Validity was evaluated by Pearson's correlation, Bland-Altman analysis, and by assessing the prognostic value of AI and PWV to predict cardiovascular (CV) mortality over 29 months.

Results: Correlation between AI(P) and AI(A) was significant (R = 0.527, p < 0.001). The mean difference of AI values obtained by the two devices was -20.6%, and 30% of the paired AI differences fall outside the +/-1 SD boundary of the mean between-device difference. There was no significant correlation between the PWV(P) and PWV(A) readings (R = 0.173, p = 0.097). The average difference of PWV values by the two devices was -1.2 m/s, and 20.6% of the paired PWV differences fall outside the +/-1 SD boundary. In survival analyses, only PWV(P) but not PWV(A) was significantly related to CV mortality.

Conclusion: Lack of correlation between PWV(P) and PWV(A) and lack of prognostic significance of PWV(A) suggest limited validity of Arteriograph to determine PWV in patients on HD.