Improved pulse wave velocity estimation using an arterial tube-load model.
Improved pulse wave velocity estimation using an arterial tube-load model.
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DOI：
10.1109/tbme.2013.2291385
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发表时间：
2014-03
期刊：
影响因子：
--
通讯作者：
Mukkamala R
中科院分区：
文献类型：
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作者：
Mingwu Gao;Guanqun Zhang;Olivier NB;Mukkamala R
脉搏波传导速度（PWV）是反映动脉僵硬度的重要指标。它通常通过非侵入性地测量中心和外周血压（BP）和/或速度（BV）波形并且然后检测波形之间的脚到脚时间延迟来估计，其中假定不存在波反射。我们开发的技术，以改善估计PWV从相同的波形。该技术有效地估计PWV从整个波形，而不仅仅是他们的脚，通过数学消除反射波通过动脉管负载模型。以这种方式，该技术可以对伪影更鲁棒，同时在没有波反射的情况下揭示真实的PWV。我们应用该技术估计主动脉PWV从同时和顺序测量的中央和外周BP波形和同时测量的中央BV和外周BP波形从17麻醉动物在不同的干预，扰乱BP广泛。由于BP是主动脉PWV的主要急性决定因素，特别是在血管紧张度变化最小的麻醉下，我们评估了PWV估计跟踪每个受试者急性BP变化的能力。总的来说，这些技术的PWV估计比传统技术更好地跟踪BP变化（例如，舒张压均方根误差对于同时BP波形为3.4对5.2mmHg，对于BV和BP波形为7.0对12.2mmHg（p < 0.02））。随着进一步的测试，动脉管负载模型为基础的PWV估计技术可以提供更准确的动脉僵硬度监测高血压和其他患者。
Pulse wave velocity (PWV) is the most important index of arterial stiffness. It is conventionally estimated by non-invasively measuring central and peripheral blood pressure (BP) and/or velocity (BV) waveforms and then detecting the foot-to-foot time delay between the waveforms wherein wave reflection is presumed absent. We developed techniques for improved estimation of PWV from the same waveforms. The techniques effectively estimate PWV from the entire waveforms, rather than just their feet, by mathematically eliminating the reflected wave via an arterial tube-load model. In this way, the techniques may be more robust to artifact while revealing the true PWV in absence of wave reflection. We applied the techniques to estimate aortic PWV from simultaneously and sequentially measured central and peripheral BP waveforms and simultaneously measured central BV and peripheral BP waveforms from 17 anesthetized animals during diverse interventions that perturbed BP widely. Since BP is the major acute determinant of aortic PWV, especially under anesthesia wherein vasomotor tone changes are minimal, we evaluated the techniques in terms of the ability of their PWV estimates to track the acute BP changes in each subject. Overall, the PWV estimates of the techniques tracked the BP changes better than those of the conventional technique (e.g., diastolic BP root-mean-squared-errors of 3.4 vs. 5.2 mmHg for the simultaneous BP waveforms and 7.0 vs. 12.2 mmHg for the BV and BP waveforms (p < 0.02)). With further testing, the arterial tube-load model-based PWV estimation techniques may afford more accurate arterial stiffness monitoring in hypertensive and other patients.