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Validation study to determine the accuracy of central blood pressure measurement using the Sphygmocor Xcel cuff device


Schultz, MG and Picone, DS and Armstrong, MK and Black, JA and Dwyer, N and Roberts-Thomson, P and Sharman, JE, Validation study to determine the accuracy of central blood pressure measurement using the Sphygmocor Xcel cuff device, Hypertension, 76 pp. 1-7. ISSN 0194-911X (2020) [Refereed Article]

Copyright Statement

© 2020 American Heart Association, Inc.

DOI: doi:10.1161/HYPERTENSIONAHA.120.14916


Numerous devices purport to measure central (aortic) blood pressure (BP) as distinct from conventional brachial BP. This validation study aimed to determine the accuracy of the Sphygmocor Xcel cuff device (AtCor Medical, CardieX, Sydney, Australia) for measuring central BP. 296 patients (mean age 61±12 years) undergoing coronary angiography had simultaneous measurement of invasive central BP and noninvasive cuff-derived central BP using the Xcel cuff device (total n=558 individual comparisons). A subsample (n=151) also had invasive brachial BP measured. Methods were undertaken according to the Artery Society recommendations, and several calibration techniques to derive central systolic BP (SBP) were examined. Minimum acceptable error was ≤5±≤8 mm Hg. Central SBP was significantly underestimated, and with wide variability, when using the default calibration of brachial-cuff SBP and diastolic BP (DBP; mean difference±SD, -7.7±11.0 mm Hg). Similar variability was observed using other calibration methods (cuff 33% form-factor mean arterial pressure and DBP, -4.4±11.5 mm Hg; cuff 40% form-factor mean arterial pressure and DBP, 4.7±11.9 mm Hg; cuff oscillometric mean arterial pressure and DBP, -18.2±12.1 mm Hg). Only calibration with invasive central integrated mean arterial pressure and DBP was within minimal acceptable error (3.3±7.5 mm Hg). The difference between brachial-cuff SBP and invasive central SBP was 3.3±10.7 mm Hg. A subsample analysis to determine the accuracy of central-to-brachial SBP amplification showed this to be overestimated by the Xcel cuff device (mean difference 4.3±9.1 mm Hg, P=0.02). Irrespective of cuff calibration technique, the Sphygmocor Xcel cuff device does not meet the Artery Society accuracy criteria for noninvasive measurement of central BP.

Item Details

Item Type:Refereed Article
Keywords:angiography, aorta, arterial pressure, blood pressure, hypertension
Research Division:Biomedical and Clinical Sciences
Research Group:Cardiovascular medicine and haematology
Research Field:Cardiology (incl. cardiovascular diseases)
Objective Division:Health
Objective Group:Clinical health
Objective Field:Clinical health not elsewhere classified
UTAS Author:Schultz, MG (Dr Martin Schultz)
UTAS Author:Picone, DS (Dr Dean Picone)
UTAS Author:Armstrong, MK (Mr Matthew Armstrong)
UTAS Author:Black, JA (Dr Andrew Black)
UTAS Author:Dwyer, N (Dr Nathan Dwyer)
UTAS Author:Roberts-Thomson, P (Dr Philip Roberts-Thomson)
UTAS Author:Sharman, JE (Professor James Sharman)
ID Code:139261
Year Published:2020
Web of Science® Times Cited:6
Deposited By:Menzies Institute for Medical Research
Deposited On:2020-06-03
Last Modified:2021-03-24

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