The Journal of Clinical Hypertension (Jun 2021)

Validation study to determine the accuracy of central blood pressure measurement using the SphygmoCor XCEL cuff device in patients with severe aortic stenosis undergoing transcatheter aortic valve replacement

  • Jose M. De la Torre Hernández,
  • Gabriela Veiga Fernandez,
  • Jonathan Brown,
  • Fermin Sainz Laso,
  • Dae‐Hyun Lee,
  • Victor Fradejas,
  • Tamara Garcia Camarero,
  • Sammy Elmariah,
  • Ignacio Inglessis,
  • Javier Zueco,
  • Jose A. Vazquez de Prada,
  • Eyal Ben‐Assa,
  • Elazer R. Edelman

DOI
https://doi.org/10.1111/jch.14245
Journal volume & issue
Vol. 23, no. 6
pp. 1165 – 1175

Abstract

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Abstract Central aortic blood pressure could be helpful in the evaluation of patients with aortic stenosis (AS). The SphygmoCor XCEL device estimates central blood pressure (BP) measurement with its easy‐to‐use, operator‐independent procedure. However, this device has not been properly validated against invasive measurement in patients with severe AS. We evaluated the relationship between cuff‐brachial BP, transfer function‐estimated and invasively measured central aortic pressure in patients with severe AS before and after transcatheter aortic valve replacement (TAVR). Agreement between techniques was analyzed and, according to the ARTERY Society recommendations, the minimum acceptable error was a mean difference ± SD ≤5 ± ≤8 mm Hg. A total of 94 patients with AS undergoing TAVR had simultaneous non‐invasive and invasive measurements of central BP before and after the procedure. Before TAVR central systolic BP was in average slightly underestimated, though with wide variability, when using the default calibration of brachial‐cuff SBP (mean difference ± SD, −3 ± 15 mm Hg), and after TAVR the degree of underestimation increased (mean difference ± SD, −9 ± 13 mm Hg). The agreement tended to improve for those patients with low aortic gradient stenosis compared to those with high gradient at baseline (mean difference ± SD, −2 ± 11 mm Hg vs. −4 ± 17, respectively, p = .3). The cuff‐brachial systolic BP yielded numerically lower degree of agreement and weaker correlation with invasive measurements than SphygmoCor XCEL. In patients with severe AS the SphygmoCor XCEL cuff device, despite showing strong correlation, does not meet the ARTERY Society accuracy criteria for non‐invasive measurement of central SBP.

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