Limits...
A database of virtual healthy subjects to assess the accuracy of foot-to-foot pulse wave velocities for estimation of aortic stiffness.

Willemet M, Chowienczyk P, Alastruey J - Am. J. Physiol. Heart Circ. Physiol. (2015)

Bottom Line: Our numerical results confirm clinical observations: 1) carotid-femoral PWV is a good indicator of aortic stiffness and correlates well with aortic PWV; 2) brachial-ankle PWV overestimates aortic PWV and is related to the stiffness and geometry of both elastic and muscular arteries; and 3) muscular PWV (carotid-radial, femoral-ankle) does not capture the stiffening of the aorta and should therefore not be used as a surrogate for aortic stiffness.In addition, our analysis highlights that the foot-to-foot PWV algorithm is sensitive to the presence of reflected waves in late diastole, which introduce errors in the PWV estimates.In this study, we have created a database of virtual healthy subjects, which can be used to assess theoretically the efficiency of physiological indexes based on pulse wave analysis.

View Article: PubMed Central - PubMed

Affiliation: Division of Imaging Sciences and Biomedical Engineering, St. Thomas' Hospital, King's College London, London, United Kingdom; and marie.willemet@gmail.com.

Show MeSH

Related in: MedlinePlus

Variation of the brachial pressure (P; left) and flow (Q; right) waveforms induced by the variation of each parameter individually around the baseline (+ 0%). Parameters varied, from top to bottom: PWV of elastic arteries (cel) and of muscular arteries (cmusc), diameter of elastic arteries (Del) and of muscular arteries (Dmusc), heart rate (HR), stroke volume (SV), and peripheral resistance (R). The gray shaded area represents the region covered by all superposed waveforms of the entire database.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4537944&req=5

Figure 4: Variation of the brachial pressure (P; left) and flow (Q; right) waveforms induced by the variation of each parameter individually around the baseline (+ 0%). Parameters varied, from top to bottom: PWV of elastic arteries (cel) and of muscular arteries (cmusc), diameter of elastic arteries (Del) and of muscular arteries (Dmusc), heart rate (HR), stroke volume (SV), and peripheral resistance (R). The gray shaded area represents the region covered by all superposed waveforms of the entire database.

Mentions: There is a substantial change in the shape of pulse waveforms among the 3,325 virtual subjects. Figure 4 shows the individual effect of each varying parameter listed in Table 1 on the brachial pressure and flow waves around the model baseline. For pressure, increasing PWV or decreasing diameters amplifies the waveform, while decreasing HR or increasing SV or R shifts the pressure waveform up (Fig. 4, left). For the flow, muscular arterial parameters have opposite effects to elastic arterial parameters: decreasing muscular PWV or increasing muscular diameters amplifies the flow waveform, while increasing elastic PWV or decreasing elastic diameters has the same effect. Increasing SV amplifies the systolic flow waveform, while changing HR or R does not affect the flow (Fig. 4, right). Similar results were observed elsewhere in the arterial network.


A database of virtual healthy subjects to assess the accuracy of foot-to-foot pulse wave velocities for estimation of aortic stiffness.

Willemet M, Chowienczyk P, Alastruey J - Am. J. Physiol. Heart Circ. Physiol. (2015)

Variation of the brachial pressure (P; left) and flow (Q; right) waveforms induced by the variation of each parameter individually around the baseline (+ 0%). Parameters varied, from top to bottom: PWV of elastic arteries (cel) and of muscular arteries (cmusc), diameter of elastic arteries (Del) and of muscular arteries (Dmusc), heart rate (HR), stroke volume (SV), and peripheral resistance (R). The gray shaded area represents the region covered by all superposed waveforms of the entire database.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4537944&req=5

Figure 4: Variation of the brachial pressure (P; left) and flow (Q; right) waveforms induced by the variation of each parameter individually around the baseline (+ 0%). Parameters varied, from top to bottom: PWV of elastic arteries (cel) and of muscular arteries (cmusc), diameter of elastic arteries (Del) and of muscular arteries (Dmusc), heart rate (HR), stroke volume (SV), and peripheral resistance (R). The gray shaded area represents the region covered by all superposed waveforms of the entire database.
Mentions: There is a substantial change in the shape of pulse waveforms among the 3,325 virtual subjects. Figure 4 shows the individual effect of each varying parameter listed in Table 1 on the brachial pressure and flow waves around the model baseline. For pressure, increasing PWV or decreasing diameters amplifies the waveform, while decreasing HR or increasing SV or R shifts the pressure waveform up (Fig. 4, left). For the flow, muscular arterial parameters have opposite effects to elastic arterial parameters: decreasing muscular PWV or increasing muscular diameters amplifies the flow waveform, while increasing elastic PWV or decreasing elastic diameters has the same effect. Increasing SV amplifies the systolic flow waveform, while changing HR or R does not affect the flow (Fig. 4, right). Similar results were observed elsewhere in the arterial network.

Bottom Line: Our numerical results confirm clinical observations: 1) carotid-femoral PWV is a good indicator of aortic stiffness and correlates well with aortic PWV; 2) brachial-ankle PWV overestimates aortic PWV and is related to the stiffness and geometry of both elastic and muscular arteries; and 3) muscular PWV (carotid-radial, femoral-ankle) does not capture the stiffening of the aorta and should therefore not be used as a surrogate for aortic stiffness.In addition, our analysis highlights that the foot-to-foot PWV algorithm is sensitive to the presence of reflected waves in late diastole, which introduce errors in the PWV estimates.In this study, we have created a database of virtual healthy subjects, which can be used to assess theoretically the efficiency of physiological indexes based on pulse wave analysis.

View Article: PubMed Central - PubMed

Affiliation: Division of Imaging Sciences and Biomedical Engineering, St. Thomas' Hospital, King's College London, London, United Kingdom; and marie.willemet@gmail.com.

Show MeSH
Related in: MedlinePlus