Sequential tonometry as a practical method to estimate truncal pulse wave velocity

Background. Pulse wave velocity (PWV) is a surrogate marker of arteriosclerosis. It can be measured by recording pressure or flow wave signals at two recording sites of an arterial segment simultaneously or sequentially. However, it is unknown how the values of pulse wave velocity derived from various techniques can be compared. Thus, the aims of the present study were to investigate whether different techniques result in different values of PWV. Methods. We measured aortic PWV from 101 uremic and non-uremic patients using both applanation tonometry and Doppler velocimetry by sequential method. To evaluate whether there is a difference between the sequentially and simultaneously derived PWV, simultaneous method using 2 tonometer or 2 Doppler probes was also applied in 50 and 23 subjects, respectively. Results. There was no significant difference between PWV derived from sequential and simultaneous tonometry (933 ± 310 cm/s and 919 ± 301 cm/s, p = 0.09). Likewise, there was no significant difference between PWV derived from sequential and simultaneous velocimetry (778 ± 241 cm/s and 761 ± 205 cm/s, p = 0.35). However, PWV determined by sequential tonometry was significantly greater than (949 ± 315 cm/s and 735 ± 208 cm/s, respectively, p < 0.001), yet also significantly correlated with that determined by sequential velocimetry (r = 0.83, p < 0.001). Conclusions. Sequential applanation tonometry is a practical approach to measure PWV in view of technical convenience and the cost of equipment and manpower. Furthermore, we should be cautious in interpreting PWV derived from different methodologies as greater PWV value might be obtained by applanation tonometry than by Doppler velocimetry.