Reliability of pulse waveform separation analysis: effects of posture and fasting: Reliability of Waveform Separation Analysis

Abstract

Oscillometric pulse wave analysis devices enable, with relative simplicity and objectivity, the measurement of central hemodynamic parameters. The important parameters are central blood pressures and indices of arterial wave reflection, including wave separation analysis (backward pressure component [Pb], reflection magnitude [RM]). Objective: This study sought to determine whether the measurement precision (between-day reliability) of Pb and RM: (i) exceeds the criterion for acceptable reliability; (ii) is affected by posture (supine, seated) and fasting state. Twenty healthy adults (50% F, 27.9 y, 24.2 kg/m2) were tested on six different mornings: three days fasted, three days non-fasted. On each occasion participants were tested in supine and seated postures. Oscillometric pressure waveforms were recorded on the left upper arm. Results: The criterion intra-class correlation coefficient value of 0.75 was exceeded for Pb (0.76) and RM (0.77) when participants were assessed under the combined supine-fasted condition. The ICC was lowest for Pb in seated-non-fasted condition (0.57), and lowest for RM in the seated-fasted condition (0.56). For Pb, the smallest detectible change (SDC) that must be exceeded in order for a significant change to occur in an individual was 2.5 mm Hg, and for RM the SDC was 8.5%. Conclusion: Assessments of Pb and RM: (i) exceed the criterion for acceptable reliability, and (ii) are most reliable when participants are fasted in a supine position. The demonstrated reliability suggests sufficient precision to detect clinically meaningful changes in RM and Pb.

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ORCID for Danielle Lambrick: orcid.org/0000-0002-0325-6015

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