A database of virtual healthy subjects to assess the accuracy of foot-to-foot pulse wave velocities for estimation of aortic stiffness.
A database of virtual healthy subjects to assess the accuracy of foot-to-foot pulse wave velocities for estimation of aortic stiffness.
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DOI：
10.1152/ajpheart.00175.2015
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发表时间：
2015-08-15
期刊：
影响因子：
--
通讯作者：
Alastruey J
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文献类型：
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作者：
Willemet M;Chowienczyk P;Alastruey J
这项工作提出了一种新的方法论的理论评估计算的生理指标和算法的基础上脉搏波分析。我们使用动脉血流动力学的1D模型创建了虚拟健康受试者的数据库。这项研究提出了其应用于中央和外周脚到脚脉搏波速度。虽然中心（颈动脉-股动脉）足-足脉搏波速度（PWV）被认为是估计主动脉僵硬度的金标准，但外周足-足PWV（臂-踝、股-踝和颈动脉-桡动脉）正被研究作为该中心测量的替代品。我们提出了一种新的方法来评估理论上这些计算的指数和与之相关的血流动力学机制。我们使用经验证的动脉血流动力学一维模型创建了3，325名虚拟健康成人受试者的数据库，心脏和动脉参数在生理健康范围内变化。对于每个虚拟受试者，从通常进行临床测量的相同位置处的数值压力波形计算脚到脚PWV。我们的数值结果证实了临床观察：1）颈-股动脉PWV是主动脉僵硬度的良好指标，与主动脉PWV相关性良好：2）臂-踝PWV高估了主动脉PWV，与弹性动脉和肌性动脉的僵硬度和几何形状相关;（3）肌肉PWV（颈动脉-桡动脉，股动脉-踝关节）不能捕获主动脉硬化，因此不应用作主动脉硬化的替代。此外，我们的分析强调，脚到脚的PWV算法是敏感的反射波的存在下，在后期反射波，引入错误的PWV估计。在这项研究中，我们已经创建了一个虚拟健康受试者的数据库，它可以用来评估理论上的有效性的生理指标的基础上脉搏波分析。
This work presents a new methodology for the theoretical assessment of computed physiological indexes and algorithms based on pulse wave analysis. We created a database of virtual healthy subjects using a 1D model of the arterial hemodynamics. This study presents its application to central and peripheral foot-to-foot pulse wave velocities. While central (carotid-femoral) foot-to-foot pulse wave velocity (PWV) is considered to be the gold standard for the estimation of aortic arterial stiffness, peripheral foot-to-foot PWV (brachial-ankle, femoral-ankle, and carotid-radial) are being studied as substitutes of this central measurement. We present a novel methodology to assess theoretically these computed indexes and the hemodynamics mechanisms relating them. We created a database of 3,325 virtual healthy adult subjects using a validated one-dimensional model of the arterial hemodynamics, with cardiac and arterial parameters varied within physiological healthy ranges. For each virtual subject, foot-to-foot PWV was computed from numerical pressure waveforms at the same locations where clinical measurements are commonly taken. 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.