VICORDER® Pulse Wave Velocity (PWV)

Validated Agreement with the Gold Standard

VICORDER® was validated in several scientific studies (345613) conducted by independent, internationally renowned institutions, in comparison with other instruments or invasive procedures. These studies confirmed the high accuracy of attained VICORDER® testing parameters when matched against Gold Standards. The documented high intra- and inter-operator reproducibility confirm the instruments extraordinary operator independence, in particular in PWVcf protocols. According to the criteria of the ARTERY Society Recommendations7 the accuracy of PWVcf measured by VICORDER® was classified as “excellent” in comparison to reference methods6.

Don’t Be Misled by a Fake PWV

With VICORDER® you are able to measure PWVcf, between the carotid and the femoral arteries, a Gold Standard measure of arterial stiffness, as postulated by scientific societies. Don’t be misled by some oscillometric devices, based on a one channel assessment of brachial pressure through an upper arm cuff only – without the recording of a second pressure wave, claiming to “measure” PWV. In reality, only reflection dependent oscillations on the brachial wave are evaluated leading to reflection times, not pulse wave transit times. At best, these methods will allow an indirect estimation of PWV only, as neither reflection points can be localized, nor can dependence on reflection properties be excluded. In particular, when the potential travel distance of the pulse wave is not measured but again estimated from body height, one should not refer to this indirect PWV approximation as a “measurement”. Several studies have shown substantial differences between reflection dependent PWV estimation and Gold Standard PWVcf. In one instrument, deviations of more than +3.5 m/s were documented leading to the conclusion that results cannot be exchanged with those obtained by other devices8. This implies that aortic PWV norms published by the ESC and ECH9 can hardly be applied in these instruments.

Simple and Safe Application in Pediatrics and Epidemiology

VICORDER® is also well suited for application in young adults and children, even in babies and neonates. The direct measurement of pulse wave transit time and distance enables an exact determination of PWVcf without any patient cooperation, offering optimum comfort, operator independence, also in obese patients. Due to the simple and fast application, usually in less than five minutes, without the removal of clothes, VICORDER® offers the method of choice in clinical and epidemiological studies. Normative data in children and adolescents have been published610.

Excellent Results also in the Private Office and Outpatient Clinic

Evaluation of arterial stiffness by VICORDER®, in particular through PWVcf, constitutes a substantial advancement in the follow-up of hypertonic patients. Assessment of the individual risk towards severe cardio-vascular events as well as the choice and titration of therapy can directly be derived. In combination with the Ankle-Brachial-Index (ABI), incorporated in any VICORDER® model, simple, fast, yet sound functional diagnostics can be offered, while tests can safely be delegated safely to techs and nurses.

Advantages of VICORDER® PWV Measurement

  • Fast test, typically in three minutes
  • Synchronous highly precise measurement of transit time
  • Synchronous pressure wave display for optimal verfication
  • Concise documentation of waves and parameters
  • Auto-Storage of patient and test data
  • Networking and central archive
  • Optional export of all results into CSV files

Literature:

1 Laurent S. et al. Central aortic blood pressure. Elsevier, 2008

2 Urbina, EM et al. Noninvasive Assessment of Subclinical Atherosclerosis in Children and Adolescents. Recommendations for Standard Assessment for Clinical Research. Hypertension 2009.

3 Hickson SS et al. Validity and repeatability of the VICORDER® apparatus: A comparison with the SphygmoCor device. Hypertension Research 2009

4 Kracht D et al. Validating a New Oscillometric Device for Aortic Pulse Wave Velocity Measurements in Children and Adolescents. Am J Hypert 2011.

5 Redheuil A et al. Measuring aortic distensibility with CMR using central pressures estimated in the magnet: comparison with carotid and peripheral pressures. Journal of Cardiovascular Magnetic Resonance 2011

6 Kis E et al. Measurement of pulse wave velocity in children and young adults: a comparative study using three different devices. Hypertension Research 2011

7 Wilkinson IB et al. On behalf of the ARTERY Society. ARTERY Society guidelines for validation of non-invasive haemodynamic measurement devices: part 1, arterial pulse wave velocity. Artery Res 2010

8 Noor A et al. Assessment of arterial stiffness in hypertension: comparison of oscillometric (Arteriograph), piezoelectronic (Complior) and tonometric (SphygmoCor) techniques. Journal of Hypertension 2009

9 ’The Reference Values for Arterial Stiffness’ Collaboration. Determinants of pulse wave velocity in healthy people and in the presence of cardiovascular risk factors: ‘Establishing normal and reference values. European Heart Journal 2010

10 Kracht D et al. Normal Values for Aortic Pulse Wave Velocity in a Pediatric Population. Journal of Hypertension Vol 29, e-Supplement A, June 2011, e118

11 Blacher J et al. Impact of Aortic Stiffness on Survival in End-Stage Renal Disease. Circulation 1999

12 Vlachopoulos C et al. Prediction of Cardiovascular Events and All-Cause Mortality With Arterial Stiffness: A Systematic Review and Meta-Analysis. J. Am. Coll. Cardiol. 2010

13 G. Pucci 1,2,3, J. Cheriyan 1,3, A. Hubsch 1, Stacey S. Hickson 1, PR. Gajendragadkar 1, T. Watson 3, M. O’Sullivan 3, J. Woodcock-Smith 1, G. Schillaci 2, Ian B. Wilkinson 1, CM. McEniery 1. Evaluation of the Vicorder, a novel cuff-based device for the noninvasive estimation of central blood pressure. Journal of Hypertension 2012, 30:000–000, online Prepublication