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Carotid pulse wave analysis

left or right, does it matter?

Pereira, Telmoa; Domingues, Saraa; Maldonado, Joãob; Conde, Jorgea

doi: 10.1097/MBP.0000000000000352
Clinical Studies and Pathophysiology

Introduction Pulse wave analysis (PWA) over the carotid artery is one of the available methodological options to obtain central arterial pressures and other important hemodynamic parameters. However, limited data exist relating the PWA estimates of one carotid artery over the contralateral one as the majority of the available data rely on measures over the right carotid artery.

Objective To evaluate the agreement of the PWA estimates between the right carotid artery and the left carotid artery.

Patients and methods A cross-sectional study of 38 patients, with a mean age of 28.85±1.70 years, was carried out. Brachial blood pressure was evaluated using a sphygmomanometer. Subsequently, PWA was obtained randomly over the left or the right carotid arteries with the Complior Analyse. All the evaluations were performed by the same experienced operator.

Results The overall mean differences observed by comparing the obtained parameters in each carotid territory were −1.50±8.06 mmHg for central systolic blood pressure (SBP), −1.63±7.98 mmHg for central pulse pressure, −3.37±27.80% for the augmentation index, and 1.50±8.06 mmHg for the SBP amplification, and were not statistically significant for all the parameters. The Bland–Altman analysis showed distinct correlations and concordance levels for different parameters: central SBP and central pulse pressure showed a very strong agreement (intraclass correlation of 0.926 and 0.886, respectively). In contrast, the concordance for the augmentation index and the SBP amplification was moderate (intraclass correlations between 0.5 and 0.8).

Conclusion PWA provides similar measures of central blood pressure, whether measured over the right or the left carotid arteries, even though the morphological features of the pulse waves showed moderate agreement. The advantages of PWA over each arterial territory and the requirements that should mediate the choice of one of the both sides require further investigation.

aClinical Physiology Department, Polytechnique Institute of Coimbra, ESTeSC

bInstitute of Cardiovascular Research, Coimbra, Portugal

Correspondence to Telmo Pereira, MSc, PhD, Rua General Humberto Delgado, 102, 3200-242 Lousã, Portugal Tel: +351 239 995 319; fax: +351 239 802 430; e-mail:

Received November 2, 2017

Received in revised form September 26, 2018

Accepted October 18, 2018

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