Details

Autor(en) / Beteiligte

• Vennin, Samuel
• Li, Ye
• Mariscal-Harana, Jorge
• Charlton, Peter H.
• Fok, Henry
• Gu, Haotian
• Chowienczyk, Phil
• Alastruey, Jordi

Titel

Novel Pressure Wave Separation Analysis for Cardiovascular Function Assessment Highlights Major Role of Aortic Root

Ist Teil von

• IEEE transactions on biomedical engineering, 2022-05, Vol.69 (5), p.1707-1716

Ort / Verlag

United States: IEEE

Erscheinungsjahr

2022

Link zum Volltext

Quelle

IEEE Electronic Library (IEL)

Beschreibungen/Notizen

• Objective: A novel method was presented to separate the central blood pressure wave (CBPW) into five components with different biophysical and temporal origins. It includes a time-varying emission coefficient (<inline-formula><tex-math notation="LaTeX">{\boldsymbol{\gamma}}</tex-math></inline-formula>) that quantifies pulse wave generation and reflection at the aortic root. Methods: The method was applied to normotensive subjects with modulated physiology by inotropic/vasoactive drugs (n = 13), hypertensive subjects (n = 158), and virtual subjects (n = 4,374). Results: <inline-formula><tex-math notation="LaTeX">{\boldsymbol{\gamma}}</tex-math></inline-formula> is directly proportional to aortic flow throughout the cardiac cycle. Mean peak <inline-formula><tex-math notation="LaTeX">{\boldsymbol{\gamma}}</tex-math></inline-formula> increased with increasing pulse pressure (from <30 to >70 mmHg) in the hypertensive (from 1.6 to 2.5, P < 0.001) and in silico (from 1.4 to 2.8, P < 0.001) groups, dobutamine dose (from baseline to 7.5 μg/kg/min) in the normotensive group (from 2.1 to 2.7, P < 0.05), and remained unchanged when peripheral wave reflections were suppressed in silico . This was accompanied by an increase in the percentage contribution of the cardiac-aortic-coupling component of CBPW in systole: from 11% to 23% (P < 0.001) in the hypertensive group, 9% to 21% (P < 0.001) in the in silico group, and 17% to 23% (P < 0.01) in the normotensive group. Conclusion: These results suggest that the aortic root is a major reflection site in the systemic arterial network and ventricular-aortic coupling is the main determinant in the elevation of pulsatile pulse pressure. Significance: Ventricular-aortic coupling is a prime therapeutic target for preventing/treating systolic hypertension.