Comparison of brachial artery pressure and derived central pressure in the measurement of abdominal aortic aneurysm distensibility

K. Wilson, H. MacCallum, I. B. Wilkinson, P. R. Hoskins, A. J. Lee, A. W. Bradbury

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Objective: AAA distensibility (Ep, β) may predict growth and risk of rupture. However, distensibility measurements based on brachial rather than central pressure may be inaccurate. Our aim was to compare AAA distensibility using non-invasive brachial and derived central aortic pressure. Design: brachial and central pressures were measured prospectively by automated sphygmomanometry (Omron) and pulse wave analysis (SphygmoCor) respectively. AAA distensibility was calculated using brachial (Epb, βb) and central (Epc, βc) pressures by ultrasonic echo-tracking (Diamove). Twenty-eight patients (18 males) were selected on a first come basis from a larger study of AAA patients. There were no exclusion criteria, so 54% had cardiac dysfunction (MI, angina) and 14% were hypertensive (BP>140/90 mmHg). Results: median (IQR) age was 74 (70-77) years, median AAA (IQR) diameter was 44 (40-51) mm. Central and brachial systolic pressures were significantly different, [140 (121-153) vs 144 (130-164) mmHg respectively, p ≤ 0.01]. Central and brachial diastolic pressures were not significantly different [76 (72-86) vs 76 (71-86) mmHg respectively, p = 0.5]. Epc (3.0, [2.2-4.9]) and βc (22.2 [15.5-33.2]) were significantly lower than Epb (3.6, [2.4-5.1] 105Nm-2) and βb (24.7 [17.1-33.0] a.u., all p<0.001. Brachial and central derived distensibility remained significantly different after adjusting for age and diameter (p<0.001). Conclusion: the use of brachial pressure leads to a small, systematic overestimate of Ep (18%) and β (11%) independent of age and AAA diameter. This systematic error will not bias follow-up of changes in distensibility.

LanguageEnglish
Pages355-360
Number of pages6
JournalEuropean Journal of Vascular and Endovascular Surgery
Volume22
Issue number4
DOIs
Publication statusPublished - 2001
Externally publishedYes

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Brachial Artery
Abdominal Aortic Aneurysm
Arm
Pressure
Blood Pressure
Pulse Wave Analysis
Ultrasonics
Rupture
Arterial Pressure
Growth

Keywords

  • Abdominal aortic aneurysm
  • Blood pressure
  • Distensibility

Cite this

Wilson, K. ; MacCallum, H. ; Wilkinson, I. B. ; Hoskins, P. R. ; Lee, A. J. ; Bradbury, A. W. / Comparison of brachial artery pressure and derived central pressure in the measurement of abdominal aortic aneurysm distensibility. In: European Journal of Vascular and Endovascular Surgery. 2001 ; Vol. 22, No. 4. pp. 355-360.
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abstract = "Objective: AAA distensibility (Ep, β) may predict growth and risk of rupture. However, distensibility measurements based on brachial rather than central pressure may be inaccurate. Our aim was to compare AAA distensibility using non-invasive brachial and derived central aortic pressure. Design: brachial and central pressures were measured prospectively by automated sphygmomanometry (Omron) and pulse wave analysis (SphygmoCor) respectively. AAA distensibility was calculated using brachial (Epb, βb) and central (Epc, βc) pressures by ultrasonic echo-tracking (Diamove). Twenty-eight patients (18 males) were selected on a first come basis from a larger study of AAA patients. There were no exclusion criteria, so 54{\%} had cardiac dysfunction (MI, angina) and 14{\%} were hypertensive (BP>140/90 mmHg). Results: median (IQR) age was 74 (70-77) years, median AAA (IQR) diameter was 44 (40-51) mm. Central and brachial systolic pressures were significantly different, [140 (121-153) vs 144 (130-164) mmHg respectively, p ≤ 0.01]. Central and brachial diastolic pressures were not significantly different [76 (72-86) vs 76 (71-86) mmHg respectively, p = 0.5]. Epc (3.0, [2.2-4.9]) and βc (22.2 [15.5-33.2]) were significantly lower than Epb (3.6, [2.4-5.1] 105Nm-2) and βb (24.7 [17.1-33.0] a.u., all p<0.001. Brachial and central derived distensibility remained significantly different after adjusting for age and diameter (p<0.001). Conclusion: the use of brachial pressure leads to a small, systematic overestimate of Ep (18{\%}) and β (11{\%}) independent of age and AAA diameter. This systematic error will not bias follow-up of changes in distensibility.",
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Comparison of brachial artery pressure and derived central pressure in the measurement of abdominal aortic aneurysm distensibility. / Wilson, K.; MacCallum, H.; Wilkinson, I. B.; Hoskins, P. R.; Lee, A. J.; Bradbury, A. W.

In: European Journal of Vascular and Endovascular Surgery, Vol. 22, No. 4, 2001, p. 355-360.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Comparison of brachial artery pressure and derived central pressure in the measurement of abdominal aortic aneurysm distensibility

AU - Wilson, K.

AU - MacCallum, H.

AU - Wilkinson, I. B.

AU - Hoskins, P. R.

AU - Lee, A. J.

AU - Bradbury, A. W.

PY - 2001

Y1 - 2001

N2 - Objective: AAA distensibility (Ep, β) may predict growth and risk of rupture. However, distensibility measurements based on brachial rather than central pressure may be inaccurate. Our aim was to compare AAA distensibility using non-invasive brachial and derived central aortic pressure. Design: brachial and central pressures were measured prospectively by automated sphygmomanometry (Omron) and pulse wave analysis (SphygmoCor) respectively. AAA distensibility was calculated using brachial (Epb, βb) and central (Epc, βc) pressures by ultrasonic echo-tracking (Diamove). Twenty-eight patients (18 males) were selected on a first come basis from a larger study of AAA patients. There were no exclusion criteria, so 54% had cardiac dysfunction (MI, angina) and 14% were hypertensive (BP>140/90 mmHg). Results: median (IQR) age was 74 (70-77) years, median AAA (IQR) diameter was 44 (40-51) mm. Central and brachial systolic pressures were significantly different, [140 (121-153) vs 144 (130-164) mmHg respectively, p ≤ 0.01]. Central and brachial diastolic pressures were not significantly different [76 (72-86) vs 76 (71-86) mmHg respectively, p = 0.5]. Epc (3.0, [2.2-4.9]) and βc (22.2 [15.5-33.2]) were significantly lower than Epb (3.6, [2.4-5.1] 105Nm-2) and βb (24.7 [17.1-33.0] a.u., all p<0.001. Brachial and central derived distensibility remained significantly different after adjusting for age and diameter (p<0.001). Conclusion: the use of brachial pressure leads to a small, systematic overestimate of Ep (18%) and β (11%) independent of age and AAA diameter. This systematic error will not bias follow-up of changes in distensibility.

AB - Objective: AAA distensibility (Ep, β) may predict growth and risk of rupture. However, distensibility measurements based on brachial rather than central pressure may be inaccurate. Our aim was to compare AAA distensibility using non-invasive brachial and derived central aortic pressure. Design: brachial and central pressures were measured prospectively by automated sphygmomanometry (Omron) and pulse wave analysis (SphygmoCor) respectively. AAA distensibility was calculated using brachial (Epb, βb) and central (Epc, βc) pressures by ultrasonic echo-tracking (Diamove). Twenty-eight patients (18 males) were selected on a first come basis from a larger study of AAA patients. There were no exclusion criteria, so 54% had cardiac dysfunction (MI, angina) and 14% were hypertensive (BP>140/90 mmHg). Results: median (IQR) age was 74 (70-77) years, median AAA (IQR) diameter was 44 (40-51) mm. Central and brachial systolic pressures were significantly different, [140 (121-153) vs 144 (130-164) mmHg respectively, p ≤ 0.01]. Central and brachial diastolic pressures were not significantly different [76 (72-86) vs 76 (71-86) mmHg respectively, p = 0.5]. Epc (3.0, [2.2-4.9]) and βc (22.2 [15.5-33.2]) were significantly lower than Epb (3.6, [2.4-5.1] 105Nm-2) and βb (24.7 [17.1-33.0] a.u., all p<0.001. Brachial and central derived distensibility remained significantly different after adjusting for age and diameter (p<0.001). Conclusion: the use of brachial pressure leads to a small, systematic overestimate of Ep (18%) and β (11%) independent of age and AAA diameter. This systematic error will not bias follow-up of changes in distensibility.

KW - Abdominal aortic aneurysm

KW - Blood pressure

KW - Distensibility

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U2 - 10.1053/ejvs.2001.1465

DO - 10.1053/ejvs.2001.1465

M3 - Article

VL - 22

SP - 355

EP - 360

JO - European Journal of Vascular and Endovascular Surgery

T2 - European Journal of Vascular and Endovascular Surgery

JF - European Journal of Vascular and Endovascular Surgery

SN - 1078-5884

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