title: Reproducibility of pulse wave analysis and pulse wave velocity in patients with type 2 diabetes.
abstract: OBJECTIVE
  Patients with type 2 diabetes have increased arterial stiffness and a high incidence of cardiovascular disease compared with non-diabetics. Arterial stiffness and central waveforms can be assessed by carotid-femoral pulse wave velocity (PWV) and pulse wave analysis (PWA) using the SphygmoCor device. These methods can potentially improve cardiovascular risk stratification in the future. However, a prerequisite is acceptable reproducibility. The objective of this study was to assess the intra- and inter-observer reproducibility of PWV and PWA indices in patients with type 2 diabetes using the SphygmoCor device.
  
  
  METHODS
  Two trained observers (A and B) each undertook two PWA and two carotid-femoral PWV recordings in random order in 20 patients with type 2 diabetes under standardized conditions on the right side of the patients. Observer A also made double recordings on the left side. The mean of the two recordings was used for inter-observer comparison. Data were analyzed by Bland-Altman plots.
  
  
  RESULTS
  The mean intra-observer differences (± 2SD) on the right side for observer A and B, respectively, were 0.0 ± 2.8 mmHg and 0.3 ± 3.2 mmHg (aortic systolic blood pressue (BP)), 0.0 ± 1.2 mmHg and 0.1 ± 1.0 mmHg (aortic diastolic BP), - 1.1 ± 3.2% and 1.1 ± 9.6% (central augmentation index (Aix)), - 1.6 ± 6.6% and 0.1 ± 9.0% (Aix normalized to heart rate 75 beats/min (Aix@HR75)) and 0.1 ± 1.8 m/s and 0.0 ± 1.6 m/s (PWV). The mean inter-observer differences (± 2SD) were - 2.6 ± 13.0 mmHg (aortic systolic BP), - 2.1 ± 7.4 mmHg (aortic diastolic BP), - 0.8 ± 8.4% (Aix), - 1.5 ± 7.4% (Aix@HR75) and - 0.3 ± 1.6 m/s (PWV). Left-vs-right comparison showed comparable results (observer A).
  
  
  CONCLUSIONS
  PWA and PWV assessed with the SphygmoCor device are characterized by good reproducibility in patients with type 2 diabetes.
authors.affiliation: Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Noerrebrogade, Denmark. esben.laugesen@ki.au.dk
authors.forename: Esben
authors.initials: E
authors.lastname: Laugesen
authors.forename: Niklas B
authors.initials: NB
authors.lastname: Rossen
authors.forename: Pernille
authors.initials: P
authors.lastname: Høyem
authors.forename: Jens S
authors.initials: JS
authors.lastname: Christiansen
authors.forename: Søren T
authors.initials: ST
authors.lastname: Knudsen
authors.forename: Klavs W
authors.initials: KW
authors.lastname: Hansen
authors.forename: Troels K
authors.initials: TK
authors.lastname: Hansen
authors.forename: Per L
authors.initials: PL
authors.lastname: Poulsen
mesh_terms: D000368:Aged; D002339:Carotid Arteries / Q000503:physiopathology; D002340:Carotid Artery Diseases / Q000175:diagnosis* / Q000209:etiology; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000503:physiopathology*; D005260:Female; D005263:Femoral Artery / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D063177:Pulse Wave Analysis; D015203:Reproducibility of Results; D059289:Vascular Stiffness