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AGREEMENT BETWEEN TWO MEASURES OF CAROTID-CEREBRAL PULSE WAVE VELOCITY AS MEASURED WITH TRANSCRANIAL DOPPLER AND PHOTOPLETHYSMOGRAPHY

Abstract

Madeline L. Rheault, Alexander Pomeroy, Jacklyn Rojas, Craig Paterson, Lee Stoner, FACSM. University of North Carolina, Chapel Hill, NC.

BACKGROUND: While the relationship between stroke and cardiovascular risk factors such as central arterial stiffness are well-established, measures of cerebral arterial stiffness, specifically carotid-cerebral pulse wave velocity (ccPWV), are underdeveloped. More easily accessible methods of cerebral arterial stiffness would allow for further insight and quantification of stroke risk. The current methodology for assessing ccPWV requires the use of two transcranial doppler ultrasound (TCD) probes. TCD is a method that is costly and requires a great deal of operator training to acquire a measurement. Photoplethysmography (PPG) is a measure that could potentially be used in conjunction with TCD as a measure of continuous ccPWV. PPG is a much more accessible piece of equipment that allows for continuous measurement of arterial stiffness. The purpose of this study was to determine the agreement of TCD-derived and TCD/PPG derived ccPWV, which may identify a simpler method for clinicians seeking information on potential risk of stroke. METHODS: This study included a sample of n=5 participants (age 26.6 ± 5.9 y). Agreement was determined by comparing the ccPWV measures taken using TCD and TCD + PPG. Agreement was determined using the correlation class coefficient (CCC) when comparing the test devices to the criterion in the supine, seated, and semi-recumbent positions. When comparing against the criterion, ccPWV, the test measures were considered accurate if the absolute standard error of estimate is <1.0 m/s, which is considered to be a clinically meaningful change. RESULTS: Data analysis is ongoing, however, an interim analysis performed on a sample of n=5 indicated a CCC [1] = 0.162. CONCLUSIONS: While this interim analysis indicated poor agreement between the two measures, sample size was a limiting factor. Data collection is ongoing, with the aim being a total sample size of n=40 participants. As a result, agreement between these two methods may improve, indicating that TCD/PPG derived ccPWV can be used as a more readily available and accessible method for clinicians to assess stroke risk.

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