Validation of Arteriograph – A New Oscillometric Device to Measure Arterial Stiffness in Patients on Maintenance Hemodialysis

Abstract

<i>Background:</i> 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<sub>A</sub>, PWV<sub>A</sub>) was compared to the validated PulsePen tonometer (AI<sub>P</sub>, PWV<sub>P</sub>). <i>Methods:</i> 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. <i>Results:</i> Correlation between AI<sub>P</sub> and AI<sub>A</sub> 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<sub>P</sub> and PWV<sub>A</sub> 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<sub>P</sub> but not PWV<sub>A</sub> was significantly related to CV mortality. <i>Conclusion:</i> Lack of correlation between PWV<sub>P</sub> and PWV<sub>A</sub> and lack of prognostic significance of PWV<sub>A</sub> suggest limited validity of Arteriograph to determine PWV in patients on HD.