Validity and reliability of peripheral pulse wave velocity measures in a seated posture,Hypertension Research

当前位置： X-MOL 学术 › Hypertens. Res. › 论文详情

Our official English website, www.x-mol.net, welcomes your feedback! (Note: you will need to create a separate account there.)

Validity and reliability of peripheral pulse wave velocity measures in a seated posture
Hypertension Research ( IF 4.3 ) Pub Date : 2020-03-09 , DOI: 10.1038/s41440-020-0424-2
Robert J Kowalsky _{1,

2} , Lee Stoner ₃ , Sophy J Perdomo ₂ , John Michael Taormina ₂ , Melissa A Jones ₂ , Daniel P Credeur ₄ , Bethany Barone Gibbs ₂

Affiliation

Excessive sedentary behavior is a risk factor for arterial stiffness, cardiovascular disease, and mortality [1, 2]. Experimental studies report vascular impairment from prolonged sitting protocols of 3–6 h in length [3, 4], and interrupting sedentary behavior appears to mitigate these detrimental effects [3]. However, the acute effects of prolonged sitting on pulse wave velocity (PWV) are unclear. Guidelines recommend assessment of PWV in a supine posture [5], yet the true effect of prolonged sitting on PWV may be impacted by the seated-to-supine posture change prior to measurement. Though measurement in a seated posture may thus be preferred, the measurement properties of PWV while maintaining a seated posture are unknown. Thus, we studied the validity (two tests) and reliability (one test) of PWV assessment in a seated posture. Twenty men and women with no contraindications for PWV testing participated in a randomized crossover study (SIT vs. SUPINE). The experimental conditions were separated by at least 2, but not more than 13, days and followed 12 h of abstention from food, caffeine, nicotine, alcohol, and moderate-to-vigorous physical activity. During each experimental visit, participants completed counterbalanced assessments of both seated and supine carotidradial (crPWV) and carotid-ankle (caPWV) PWV after a 10min rest. Following this, at each visit, in counterbalanced postures, subjects consumed 300 mg of caffeine, which served as a standardized perturbation. PWV was measured at 10, 20, and 30 min postcaffeine consumption. PWV was measured by a Complior Analyze system (ALAM Medical, France), with three separate scans of ten valid waveforms at each time point. Intraclass correlations (ICCs) were calculated to determine reliability across testing days; ICC ≥ 0.75 was considered good reliability. Pearson’s correlations (r) determined the validity of seated (alternative method) versus supine (gold standard) peripheral PWV measurements. Generalized linear mixed models evaluated differences in PWV response across time points, adjusting for age, sex, and condition order. On average, participants were 25.9 (7.7) years old with a BMI of 25.5 (4.3) kg/m and resting blood pressure of 115/ 70 (10/9) mmHg. Half (50%) of the participants were male and 85% were white. When measured in the supine posture (gold standard), day-to-day reliability had an ICC= 0.636 (95% Confidence Interval (CI) 0.279–0.838) for crPWV and an ICC= 0.361 (95% CI 0.099–0.694) for caPWV. In the seated posture (alternative method), ICC= 0.768 (95% CI 0.502–0.901) for crPWV, and ICC= 0.759 (95% CI 0.475–0.900) for caPWV. Only the seated peripheral PWV assessment met the criteria for good reliability (≥0.75) (Fig. 1). Supine versus seated peripheral PWV measurements at rest (Fig. 2a, b) suggested high agreement for crPWV (r= 0.812 95%, CI 0.563–0.943) but low agreement for caPWV (r= 0.277, 95% CI 0.119–0.543). During the caffeine perturbation (Fig. 2c, d), peripheral PWV condition × time interactions were nonsignificant (p ≥ 0.10), suggesting similar responses across postures. Peripheral PWV was significantly higher in the seated vs. supine condition for both crPWV (βposture= 0.548 m/s, p < 0.001) and caPWV (βposture= 3.583 m/s, p < 0.001). While there was no time effect for crPWV (βtime= 0.009 m/s per 10 min, p= 0.198), caPWV increased over time in response to caffeine (βtime= 0.014 m/s per 10 min, p= 0.014). * Robert J. Kowalsky robert.kowalskyjr@tamuk.edu

中文翻译：

坐姿外周脉搏波速度测量的有效性和可靠性

久坐行为是动脉僵硬、心血管疾病和死亡率的危险因素 [1, 2]。实验研究报告了 3 至 6 小时长的久坐协议造成的血管损伤 [3, 4]，而中断久坐行为似乎可以减轻这些不利影响 [3]。然而，长时间坐着对脉搏波速度 (PWV) 的急性影响尚不清楚。指南建议在仰卧姿势下评估 PWV [5]，但长时间坐着对 PWV 的真正影响可能会受到测量前从坐姿到仰卧姿势变化的影响。尽管因此可能优选以坐姿进行测量，但在保持坐姿时PWV的测量特性是未知的。因此，我们研究了坐姿 PWV 评估的有效性（两项测试）和可靠性（一项测试）。20 名没有 PWV 测试禁忌症的男性和女性参加了一项随机交叉研究（坐姿 vs. 仰卧位）。实验条件相隔至少 2 天，但不超过 13 天，随后 12 小时禁食食物、咖啡因、尼古丁、酒精和中度至剧烈的体力活动。在每次实验访问期间，参与者在休息 10 分钟后完成对坐位和仰卧颈动脉 (crPWV) 和颈动脉踝 (caPWV) PWV 的平衡评估。在此之后，在每次访问中，受试者以平衡姿势消耗 300 毫克咖啡因，这是标准化的扰动。在摄入咖啡因后 10、20 和 30 分钟测量 PWV。PWV 是通过 Complior Analyze 系统（ALAM Medical，法国）测量的，在每个时间点对十个有效波形进行三次独立扫描。计算类内相关性 (ICC) 以确定跨测试日的可靠性；ICC ≥ 0.75 被认为是良好的可靠性。Pearson 相关性 (r) 确定了坐姿（替代方法）与仰卧（黄金标准）外周 PWV 测量的有效性。广义线性混合模型评估了 PWV 响应跨时间点的差异，调整了年龄、性别和条件顺序。参与者平均年龄为 25.9 (7.7) 岁，BMI 为 25.5 (4.3) kg/m，静息血压为 115/ 70 (10/9) mmHg。一半 (50%) 的参与者是男性，85% 是白人。当以仰卧姿势（金标准）测量时，crPWV 的日常可靠性的 ICC= 0.636（95% 置信区间 (CI) 0.279–0.838）和 ICC= 0.361（95% CI 0.099–0.694） caPWV。在坐姿中（替代方法），ICC=0。crPWV 为 768 (95% CI 0.502–0.901)，caPWV ICC = 0.759 (95% CI 0.475–0.900)。只有坐位外周 PWV 评估符合良好可靠性的标准（≥0.75）（图 1）。静息时仰卧位与坐位外周 PWV 测量值（图 2a、b）表明 crPWV 的一致性较高（r= 0.812 95%，CI 0.563–0.943），但 caPWV 的一致性较低（r= 0.277，95% CI 0.119–0.543）。在咖啡因扰动期间（图 2c、d），外周 PWV 条件 × 时间相互作用不显着（p ≥ 0.10），表明不同姿势的反应相似。crPWV（β姿势= 0.548 m/s，p < 0.001）和caPWV（β姿势= 3.583 m/s，p < 0.001）在坐位与仰卧状态下的外周PWV显着更高。虽然 crPWV 没有时间效应（βtime= 0.009 m/s 每 10 分钟，p= 0.198），caPWV 随时间增加，以响应咖啡因（βtime = 0.014 m/s 每 10 分钟，p = 0.014）。* 罗伯特 J. Kowalsky robert.kowalskyjr@tamuk.edu

更新日期：2020-03-09

点击分享查看原文

点击收藏

阅读更多本刊最新论文本刊介绍/投稿指南11