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Master Thesis

Étude multicentrique de reproductibilité de la mesure des pressions artérielles digitales chez des patients sclérodermies

Abstract : Objectives: Main objective is to evaluate the repeatability and reproducibility of digital blood pressure between a cuff on the 1st or 2nd phalanx, using laser Doppler. The secondary objectives are to compare reproducibility between 2 and 3 measures on each finger, to evaluate reproducibility depending on heating systems and to evaluate correlation between digital pressure and trophic disorders. Methods: An observational multicentric study has been conducted on 37 sclerodermic patients (Leroy and Medsger’s criteria). Digital blood pressures have been realized with laser Doppler on sclerodermic patients (3 measures on 8 fingers, placing alternately on the 1st and on the 2nd phalanx and reverse) in a room with stable temperature. A different heating system by center was studied. Results : The reproducibility of digital pressure is good without intra-subject variation using laser Doppler, whether the cuff is on 1st or 2nd phalanx (coefficient of variation (CV) of 7.6% for the distal cuff and 7.1% for the proximal cuff). There is a correlation between the values of pressures in proximal and distal on the same finger. This correlation is not excellent (Pearson coefficient to 0.7; p 0.0001). There is a systematic bias (+ 14mmHg) as the cuff is placed on proximal phalanx rather than on distal phalanx. The reproducibility of values is good if we consider only 2 measures instead of 3. The CV is best in distal with 3 measures (CV = 7.8%) than with 2 measures (CV = 8.3%), as in proximal (7.03% versus 7.5%). Heating systems are considered as equivalent. The ROC curves are in favor of a better correlation between trophic disorders and distal phalanx digital pressure. Conclusion: This study confirms a good reproducibility of digital pressure with laser Doppler whether cuff is placed on 1st or 2nd phalanx. As expected, values are better with 3 measurements per finger. Pressures on distal phalanx are better correlated with trophic disorders and confirm the choice of cuff placement on the distal phalanx to optimize the diagnosis of upper limb arteriopathy.
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Master Thesis
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Submitted on : Thursday, September 26, 2019 - 10:43:45 AM
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Laure Pellegrini. Étude multicentrique de reproductibilité de la mesure des pressions artérielles digitales chez des patients sclérodermies. Médecine humaine et pathologie. 2019. ⟨dumas-02297434⟩



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