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WatchBP Office ABI

Presenter: Willem VerberkDate: 22/04/2010 Lacer, Barcelona, Spain

© 2008 All Rights Reserved. No copy and distribution without permission.2

Microlife WatchBP Office ABI


WatchBP Office ABI : vascular screening device

•Ankle Brachial Index (ABI)

• Inter Arm Difference (IAD)

•Atrial Fibrilation screening (Afib)


WatchBP Office ABI Display


Cuffs provided with WatchBP ABI


ABI measurement

ABI= 148/136


Ankle Brachial Index (ABI)

ABI value Interpretation

above 1.3 Abnormal Vessel hardening from PVD

1.0 - 1.3 Normal range

0.9 - 1.0 Acceptable

0.8 - 0.9 Some arterial disease

0.5 - 0.8 Moderate arterial disease

under 0.5 Severe arterial disease

ABI = BPankle

BParm


Validation Procedure: Observers

• Two observers (A and B), assessed agreement in measuring SBP at the level of the brachial artery, the dorsalis pedis and the posterior tibial artery using a doppler device (5-10 MHz)

• All measurements of each individual participant were performed by the same observer (A or B, according to their availability).


Validation procedure A

STEPS

NUMBER OF SEQUENTIAL

MEASUREMENTS

O FAMILIARIZATION PHASE

WatchBP Officerandom arm – leg simultaneous recording

1 ABI 1 BP reading

A ARM SELECTION

1 WatchBP Office Both arms simultaneous recordings*

3 BP readings


Arm selection

IF IAD (consistently) >12 mmHg (Circulation 2006, ACC/AHA PDA guidelines) arm with higher BP is selected. Otherwise the right arm


STEPS

NUMBER OF SEQUENTIAL

MEASUREMENTS

B Randomized order ( 1 vs 2) ABI MEASUREMENT

1 Doppler R brachial artery L brachial artery L posterior tibial artery L dorsalis pedis artery R posterior tibial artery R dorsalis pedis artery

2 legs ABI x 1 1 SBP reading 1 SBP reading 1 SBP reading 1 SBP reading 1 SBP reading 1 SBP reading

2 WatchBP OfficeSimultaneously R leg – R arm*Simultaneously L leg – R arm*

2 Legs ABI X 3 1 BP readings x 3 1 BP readings x 3

Validation procedure B


Doppler measurements


Artery compared


WatchBP Office ABI Ankle Cuff

Posterior tibial artery


Population

93 patientsoAge 62.5±11.1 yearsoMen 62%oHypertension 83%oDiabetes 45%oDyslipidemia 72%oSmoking 15%ocardiovascular disease 23%


Results I WatchBP vs. Doppler

• 1st measurement 1.08±0.17 vs. 1.11±0.17

• Difference of Doppler vs. WatchBP•0.03 ± 0.11 (1st measurement)•0.02 ± 0.10 (average of 2 readings)•0.02±0.09 (average of 3 readings; p<0.01 for all).

• Correlation Doppler and WatchBP •0.80 (1st measurement )•0.84 (average of 2 readings)•0.86 (average of 3 readings; P < 0.001 for all)

• 95% Agreement diagnosing PAD (Doppler ABI <0.9)


• WatchBP failed to measure ABI (5 sequential errors) in 3 legs. All with Doppler ABI <0.9.

• Erroneous WatchBP readings more frequent in patients with PAD (35.2%) than without (5.7%) respectively, p<0.001).

• The average time 3.8±0.3 vs. 8.8±2.2 min (p<0.001).

Results IIWatchBP vs. Doppler


Conclusion Validation study

Automated ABI determination using Microlife WatchBP Office ABI is a quick, easy and reliable test for PAD detection

Abstract ESH Oslo 2010


Doppler vs. WatchBP Office

Difficult (education / skills required)

easy

Time consuming Fast

Calculation needed Ratio is provided

Not simultaneous Simultaneous

Auscultatory Oscillometric

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