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Pavel A. Samsonov Jul 17
Replying to @johncutlefish
Best way to break out of the whirlpool is to listen to users (not customers, not Sales). The second best way is to remove features, not add.
В Modality (device)В ParameterВ AdvantagesВ DisadvantagesВ 
Regional stiffnessВ DopplerВ cfPWVaВ 
  • Inexpensive, portable

  • Can assess other cardiac and arterial features, e.g. LV hypertrophy, strain

  • Does not require a specific device

  • Faster than applanation tonometry

  • Identification of anatomical landmarks aids repeatability of measurement position

  • Can detect occlusive/atherosclerotic lesions that may affect PWV

В 
  • Operator-dependent skill

  • Sites of measurement limited by acoustic window

  • Lacks versatility for anatomical variations

  • Method of distance measurement overestimates distance

  • Calculation of cfPWV includes iliac and femoral arteries and excludes ascending aorta

In addition:
  • Transit time is determined through visual assessment using digital calipers, limited by temporal resolution

В 
Mechano- transducer (Complior)В cfPWVВ 
  • Similar to Doppler

In addition:
  • Automated device

  • Simultaneous measurements

В 
  • Similar to Doppler

In addition:
  • Variations in transit time algorithms used

  • Underestimates PWV compared with applanation tonometry

  • Cannot provide local wall assessment, where aortic condition may vary

В 
Applanation tonometry (SpyghmoCor)В cfPWVВ 
  • Inexpensive, portable

В 
  • Similar to Doppler

In addition:
  • Two consecutive recordings needed, heart rate variability may cause confounding

  • Local wall assessment not possible

В 
Local stiffnessВ CMRВ aPWV and ADВ 
  • Local and regional assessment of aorta possible

  • Relatively operator independent

  • Full visualization of the entire vessel

  • Imaging planes can be precisely placed with good repeatability

  • Greater spatial and temporal resolution (especially 3Tesla CMR) to study the temporal shift over smaller distances

  • Measurement not affected by anatomical variations, peripheral vascular disease or problems with using probes to detect waveforms

  • Other aspects of cardiac and arterial function can be assessed, e.g. strain and deformation

В 
  • Focal measurement may be prone to sampling error

  • Image analysis can be time-consuming and user dependent

  • Expensive

  • Longer examination time than other methods

  • Not possible with patients with metal implants, or with claustrophobia

  • PP is usually determined non-invasively and peripherally as it is more feasible than invasive measurement

В 
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