title: Evaluation of a novel brachial cuff-based oscillometric method for estimating central systolic pressure in hemodialysis patients.
abstract: OBJECTIVE
  Elevated wave reflections and arterial stiffness, as well as ambulatory blood pressure (BP) are independent predictors of cardiovascular risk in end-stage-renal-disease. This study is the first to evaluate in hemodialysis patients the validity of a new ambulatory oscillometric device (Mobil-O-Graph, IEM, Germany), which estimates aortic BP, augmentation index (AIx) and pulse wave velocity (PWV).
  
  
  METHODS
  Aortic SBP (aSBP), heart rate-adjusted AIx (AIx(75)) and PWV measured with Mobil-O-Graph were compared with the values from the most widely used tonometric device (Sphygmocor, ArtCor, Australia) in 73 hemodialysis patients. Measurements were made in a randomized order after 10 min of rest in the supine position at least 30 min before a dialysis session. Brachial BP (mercury sphygmomanometer) was used for the calibration of Sphygmocor's waveform.
  
  
  RESULTS
  Sphygmocor-derived aSBP and AIx(75) did not differ from the relevant Mobil-O-Graph measurements (aSBP: 136.3 ± 19.6 vs. 133.5 ± 19.3 mm Hg, p = 0.068; AIx(75): 28.4 ± 9.3 vs. 30.0 ± 11.8%, p = 0.229). The small difference in aSBP is perhaps explained by a relevant difference in brachial SBP used for calibration (146.9 ± 20.4 vs. 145.2 ± 19.9 mm Hg, p = 0.341). Sphygmocor PWV was higher than Mobil-O-Graph PWV (10.3 ± 3.4 vs. 9.5 ± 2.1 m/s, p < 0.01). All 3 parameters estimated by Mobil-O-Graph showed highly significant (p < 0.001) correlations with the relevant measurements of Sphygmocor (aSBP, r = 0.770; AIx(75), r = 0.400; PWV, r = 0.739). The Bland-Altman Plots for aSBP and AIx(75) showed acceptable agreement between the two devices and no evidence of systemic bias for PWV.
  
  
  CONCLUSIONS
  As in other populations, acceptable agreement between Mobil-O-Graph and Sphygmocor was evident for aSBP and AIx(75) in hemodialysis patients; PWV was slightly underestimated by Mobil-O-Graph.
authors.affiliation: Department of Nephrology, Hippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
authors.forename: Pantelis A
authors.initials: PA
authors.lastname: Sarafidis
authors.forename: Panagiotis I
authors.initials: PI
authors.lastname: Georgianos
authors.forename: Antonios
authors.initials: A
authors.lastname: Karpetas
authors.forename: Athanasios
authors.initials: A
authors.lastname: Bikos
authors.forename: Linda
authors.initials: L
authors.lastname: Korelidou
authors.forename: Maria
authors.initials: M
authors.lastname: Tersi
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Divanis
authors.forename: Georgios
authors.initials: G
authors.lastname: Tzanis
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Mavromatidis
authors.forename: Vassilios
authors.initials: V
authors.lastname: Liakopoulos
authors.forename: Pantelis E
authors.initials: PE
authors.lastname: Zebekakis
authors.forename: Anastasios
authors.initials: A
authors.lastname: Lasaridis
authors.forename: Athanase D
authors.initials: AD
authors.lastname: Protogerou
mesh_terms: D000368:Aged; D001011:Aorta / Q000473:pathology; D001783:Blood Flow Velocity; D001794:Blood Pressure; D018660:Blood Pressure Monitoring, Ambulatory / Q000379:methods*; D001916:Brachial Artery / Q000473:pathology*; D002138:Calibration; D002318:Cardiovascular Diseases / Q000503:physiopathology; D005260:Female; D006339:Heart Rate; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009991:Oscillometry; D063177:Pulse Wave Analysis; D006435:Renal Dialysis / Q000379:methods*; D051437:Renal Insufficiency; D012307:Risk Factors; D016683:Supine Position; D013599:Systole; D059289:Vascular Stiffness