-Original-

A Pilot Estimation of Ventricular-Arterial Coupling Using a Vascular Screening Device (VaSera^®)

David Kanyinda Kayembe¹, Koji Hosokawa¹, Yurie Obata², Tetsuro Isada³, Hiroko Shigemi⁴ and Kenji Shigemi¹

¹Department of Anesthesiology and Reanimatology, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
²Department of Anesthesiology, Yodogawa Christian Hospital, Osaka, Japan
³Department of Anesthesia, Saitama Prefectural Children's Hospital, Saitama, Japan
⁴Department of Clinical Laboratory and Control and Prevention of Infection, Kyoto Prefectural University of Medicine, Kyoto, Japan

Background: Non-invasive cardiovascular assessment has become an alternative to invasive techniques. VaSera^®, a vascular screening device, measures arterial stiffness with the cardio-ankle vascular index (CAVI); it also measures cardiophysiological variables of ejection time (ET) and pre-ejection period (PEP). We aimed to apply the parameters obtained by VaSera^® to estimate heart function based on left ventricular end-systolic elastance/arterial elastance (Ees/Ea) and to assess the minimal required number of measurements for estimation.
Methods: We conducted an experimental laboratory study for healthy volunteers. Using the previously established formula, the Ees/Ea value of each participant was estimated using ET and PEP values measured by VaSera^®. The intraclass correlation coefficient (ICC) assessed the minimum required number of measurements. Concordance correlation coefficient (CCC) and Bland and Altman analysis assessed variation of Ees/Ea estimation against the trimmed average.
Results: A total of 660 measurements from 132 participants were included. The Ees/Ea estimates from the VaSera^® were 1.5 [1.2, 1.9]. The ICC for Ees/Ea was 0.71 (95% confidence interval: 0.65-0.77), suggesting that four measurements were required. The CCC between the trimmed average of Ees/Ea and the mean of four Ees/Ea estimates was 0.99. Bland and Altman analysis showed excellent agreement for the mean of four Ees/Ea estimates and the trimmed average of Ees/Ea.
Conclusions: For screening of heart failure, the Ees/Ea estimated using non-invasive vascular-stiffness assessment device would be tolerable and four sequential measurements were required.

J Nippon Med Sch 2023; 90: 220-227

Keywords
cardiovascular physiology, VaSera^®, ventricular function, ventricular-arterial coupling, screening

Correspondence to
Koji Hosokawa, Department of Anesthesiology and Reanimatology, Faculty of Medical Sciences, University of Fukui, 23-3 Shimoaizuki, Matsuoka, Eiheiji-cho, Yoshidagun, Fukui 910-1193, Japan
khosok@u-fukui.ac.jp

Received, October 20, 2022
Accepted, December 28, 2022