Abstract
The Complior device (Alam Medical, France) has contributed to the rise of arterial stiffness as a measure of cardiovascular risk. In its latest version (Complior Analyse) the sensor records pressure instead of distension waveforms thus allowing the measurement of central pressure and pulse wave analysis. The aim of our study was to verify that the new sensor measures pressure waveforms accurately in both time and frequency domain. Invasive and non-invasive signals were recorded simultaneously at the radial artery and compared in the frequency and time domain in haemodynamically stable intensive care unit patients. Twelve patients entered the study (8 men, 4 women, mean age 69 ± 17 years). Heart rate was 90 ± 15 bpm, systolic blood pressure 133 ± 19 mmHg and diastolic blood pressure 68 ± 15 mmHg. There was no statistical difference in the amplitude of harmonics between the invasive signal and Complior signal. When superimposing waveforms in the time domain, there was a small difference in the form factor (4.2 ± 2.8 %) and in the absolute area between the 2 waveforms (3.3 ± 1.7 mmHg·s−1). These differences were of the same magnitude as the beat-to-beat variation of the form factor (3.3 %) and of the absolute area (3.1 mmHg·s−1), respectively. The second systolic peak was detectable in 4 subjects, with no statistical difference between invasive and non-invasive values. The new pressure sensor of the Complior Analyse device recorded pressure waveforms accurately and could be used to perform pressure wave analysis.
Similar content being viewed by others
References
Vlachopoulos C, Aznaouridis K, O’Rourke MF, Safar ME, Baou K, Stefanadis C. Prediction of cardiovascular events and all-cause mortality with central haemodynamics: a systematic review and meta-analysis. Eur Heart J. 2010;31:1865–71.
Safar ME, Blacher J, Pannier B, Guerin AP, Marchais SJ, Guyonvarc’h PM, et al. Central pulse pressure and mortality in end-stage renal disease. Hypertension. 2002;39:735–8.
Pini R, Cavallini MC, Palmieri V, Marchionni N, Di BM, Devereux RB, et al. Central but not brachial blood pressure predicts cardiovascular events in an unselected geriatric population: the ICARe Dicomano Study. J Am Coll Cardiol. 2008;51:2432–9.
Wang KL, Cheng HM, Chuang SY, Spurgeon HA, Ting CT, Lakatta EG, et al. Central or peripheral systolic or pulse pressure: which best relates to target organs and future mortality? J Hypertens. 2009;27:461–7.
Roman MJ, Devereux RB, Kizer JR, Lee ET, Galloway JM, Ali T, et al. Central pressure more strongly relates to vascular disease and outcome than does brachial pressure: the Strong Heart Study. Hypertension. 2007;50:197–203.
Williams B, Lacy PS, Thom SM, Cruickshank K, Stanton A, Collier D, et al. Differential impact of blood pressure-lowering drugs on central aortic pressure and clinical outcomes: principal results of the Conduit Artery Function Evaluation (CAFE) study. Circulation. 2006;113:1213–25.
Boutouyrie P, Achouba A, Trunet P, Laurent S. Amlodipine-valsartan combination decreases central systolic blood pressure more effectively than the amlodipine-atenolol combination. the EXPLOR Study. Hypertension. 2010;55:1314–22.
Matsui Y, Eguchi K, O’Rourke MF, Ishikawa J, Shimada K, Kario K. Association between aldosterone induced by antihypertensive medication and arterial stiffness reduction: the J-CORE study. Atherosclerosis. 2011;215:184–8.
Pauca AL, O’Rourke MF, Kon ND. Prospective evaluation of a method for estimating ascending aortic pressure from the radial artery pressure waveform. Hypertension. 2001;38:932–7.
Weber T, Wassertheurer S, Rammer M, Maurer E, Hametner B, Mayer CC, et al. Validation of a brachial cuff-based method for estimating central systolic blood pressure. Hypertension. 2011;58:825–32.
Williams B, Lacy PS, Yan P, Hwee CN, Liang C, Ting CM. Development and validation of a novel method to derive central aortic systolic pressure from the radial pressure waveform using an N-point moving average method. J Am Coll Cardiol. 2011;57:951–61.
Pucci G, Cheriyan J, Hubsch A, Hickson SS, Gajendragadkar PR, Watson T, et al. Evaluation of the Vicorder, a novel cuff-based device for the noninvasive estimation of central blood pressure. J Hypertens. 2013;31:77–85.
Brett SE, Guilcher A, Clapp B, Chowienczyk P. Estimating central systolic blood pressure during oscillometric determination of blood pressure: proof of concept and validation by comparison with intra-aortic pressure recording and arterial tonometry. Blood Press Monit. 2012;17:132–6.
Pauca AL, Kon ND, O’Rourke MF. The second peak of the radial artery pressure wave represents aortic systolic pressure in hypertensive and elderly patients. Br J Anaesth. 2004;92:651–7.
Guilcher A, Brett S, Munir S, Clapp B, Chowienczyk PJ. Estimating central SBP from the peripheral pulse: influence of waveform analysis and calibration error. J Hypertens. 2011;29:1357–66.
Takazawa K, Kobayashi H, Kojima I, Aizawa A, Kinoh M, Sugo Y, et al. Estimation of central aortic systolic pressure using late systolic inflection of radial artery pulse and its application to vasodilator therapy. J Hypertens. 2012;30:908–16.
Lin MM, Cheng HM, Sung SH, Liao CF, Chen YH, Huang PH, et al. Estimation of central aortic systolic pressure from the second systolic peak of the peripheral upper limb pulse depends on central aortic pressure waveform morphology. J Hypertens. 2012;30:581–6.
Kelly RP, Karamanoglu M, Gibbs H, Avolio AP, O’Rourke MF. Noninvasive carotid pressure wave registration as an indicator of ascending aortic pressure. J Vasc Med Biol. 1989;1:241–7.
Chen CH, Ting CT, Nussbacher A, Nevo E, Kass DA, Pak P, et al. Validation of carotid artery tonometry as a means of estimating augmentation index of ascending aortic pressure. Hypertension. 1996;27:168–75.
Laurent S, Cockcroft J, Van BL, Boutouyrie P, Giannattasio C, Hayoz D, et al. Expert consensus document on arterial stiffness: methodological issues and clinical applications. Eur Heart J. 2006;27:2588–605.
Van Bortel LM, Laurent S, Boutouyrie P, Chowienczyk P, Cruickshank JK, De BT, et al. Expert consensus document on the measurement of aortic stiffness in daily practice using carotid-femoral pulse wave velocity. J Hypertens. 2012;30:445–8.
Vlachopoulos C, Aznaouridis K, Stefanadis C. Prediction of cardiovascular events and all-cause mortality with arterial stiffness: a systematic review and meta-analysis. J Am Coll Cardiol. 2010;55:1318–27.
Mancia G, De BG, Dominiczak A, Cifkova R, Fagard R, Germano G, et al. 2007 Guidelines for the management of arterial hypertension: the task force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens. 2007;25:1105–87.
Asmar R, Benetos A, Topouchian J, Laurent P, Pannier B, Brisac A-M, et al. Assessment of arterial distensibility by automatic pulse wave velocity measurement: validation and clinical application studies. Hypertension. 1995;26:485–90.
Asmar R, Topouchian J, Pannier B, Benetos A, Safar M. Pulse wave velocity as endpoint in large-scale intervention trial. the Complior study. Scientific, Quality Control, Coordination and Investigation Committees of the Complior Study. J Hypertens. 2001;19:813–8.
Pereira T, Maldonado J. Comparative study of two generations of the Complior device for aortic pulse wave velocity measurements. Blood Press Monit. 2010;15:316–21.
Chiu YC, Arand PW, Shroff SG, Feldman T, Carroll JD. Determination of pulse wave velocities with computerized algorithms. Am Heart J. 1991;121:1460–70.
Arterial Stiffness Collaboration group. Determinants of pulse wave velocity in healthy people and in the presence of cardiovascular risk factors: ‘establishing normal and reference values’. Eur Heart J. 2010.
Kips J, Vanmolkot F, Mahieu D, Vermeersch S, Fabry I, de HJ, et al. The use of diameter distension waveforms as an alternative for tonometric pressure to assess carotid blood pressure. Physiol Meas. 2010;31:543–53.
Chemla D, Hebert JL, Aptecar E, Mazoit JX, Zamani K, Frank R, et al. Empirical estimates of mean aortic pressure: advantages, drawbacks and implications for pressure redundancy. Clin Sci (Lond). 2002;103:7–13.
Kelly RP, Hayward C, Ganis J, Daley J, Avolio A, O’Rourke MF. Noninvasive registration of the arterial pressure pulse waveform; using high-fidelity applanation tonometry. J Vasc Med Biol. 1989;1:142–9.
Salvi P, Lio G, Labat C, Ricci E, Pannier B, Benetos A. Validation of a new non-invasive portable tonometer for determining arterial pressure wave and pulse wave velocity: the PulsePen device. J Hypertens. 2004;22:2285–93.
Zhang Y, Agnoletti D, Protogerou AD, Wang JG, Topouchian J, Salvi P, et al. Radial late-SBP as a surrogate for central SBP. J Hypertens. 2011;29:676–681.
Conflict of interest
Sandrine Millasseau works as a freelance specialist on pulse wave analysis and receives revenues from several medical companies including AtCor, Omron (both cited in this article) and Alam Medical whose sensors have been validated in this study. The other authors have no conflict of interest to declare in the subject matter. Alam Medical freely loaned a Complior Analyse device for the duration of the study.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Sztrymf, B., Jacobs, F., Chemla, D. et al. Validation of the new Complior sensor to record pressure signals non-invasively. J Clin Monit Comput 27, 613–619 (2013). https://doi.org/10.1007/s10877-013-9477-y
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10877-013-9477-y