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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.

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Bottom: deviation of the ratio of PWV methods along the aorta (foot-to-foot aPWVff over theoretical aPWVth) as a function of the reflection coefficient Rf at the aorto-iliac bifurcation for all 3,320 + 1,840 converging cases. Top: examples of aortic (black) and iliac bifurcation (gray) pressure waveforms for 3 values of the reflection coefficient Rf: outside (Rf = ±0.4) and inside (Rf = 0.0) the physiological limit.
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Figure 7: Bottom: deviation of the ratio of PWV methods along the aorta (foot-to-foot aPWVff over theoretical aPWVth) as a function of the reflection coefficient Rf at the aorto-iliac bifurcation for all 3,320 + 1,840 converging cases. Top: examples of aortic (black) and iliac bifurcation (gray) pressure waveforms for 3 values of the reflection coefficient Rf: outside (Rf = ±0.4) and inside (Rf = 0.0) the physiological limit.

Mentions: Figure 7, bottom, presents the ratio of aPWVff to aPWVth as a function of the reflection coefficient Rf at the aorto-iliac bifurcation, for all converging cases (i.e., 3,320 + 1,840 cases, including Rf > 0.3 and Rf < −0.3). The foot-to-foot PWV deviates from the theoretical value from 20 to 50% if Rf < −0.3, while the deviation is smaller than 5% if Rf > 0.3. Pressure waveforms in Fig. 7, top, illustrate the change in wave shape for different reflection coefficients. The pressure waveform at the iliac bifurcation presents oscillations if Rf is outside the physiological range: during the diastolic decay if Rf < −0.3 and in late systole if Rf > 0.3.


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: deviation of the ratio of PWV methods along the aorta (foot-to-foot aPWVff over theoretical aPWVth) as a function of the reflection coefficient Rf at the aorto-iliac bifurcation for all 3,320 + 1,840 converging cases. Top: examples of aortic (black) and iliac bifurcation (gray) pressure waveforms for 3 values of the reflection coefficient Rf: outside (Rf = ±0.4) and inside (Rf = 0.0) the physiological limit.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 7: Bottom: deviation of the ratio of PWV methods along the aorta (foot-to-foot aPWVff over theoretical aPWVth) as a function of the reflection coefficient Rf at the aorto-iliac bifurcation for all 3,320 + 1,840 converging cases. Top: examples of aortic (black) and iliac bifurcation (gray) pressure waveforms for 3 values of the reflection coefficient Rf: outside (Rf = ±0.4) and inside (Rf = 0.0) the physiological limit.
Mentions: Figure 7, bottom, presents the ratio of aPWVff to aPWVth as a function of the reflection coefficient Rf at the aorto-iliac bifurcation, for all converging cases (i.e., 3,320 + 1,840 cases, including Rf > 0.3 and Rf < −0.3). The foot-to-foot PWV deviates from the theoretical value from 20 to 50% if Rf < −0.3, while the deviation is smaller than 5% if Rf > 0.3. Pressure waveforms in Fig. 7, top, illustrate the change in wave shape for different reflection coefficients. The pressure waveform at the iliac bifurcation presents oscillations if Rf is outside the physiological range: during the diastolic decay if Rf < −0.3 and in late systole if Rf > 0.3.

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