A data-driven approach for addressing the lack of flow waveform data in studies of cerebral arterial flow in older adults.
A data-driven approach for addressing the lack of flow waveform data in studies of cerebral arterial flow in older adults.
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DOI：
10.1088/1361-6579/aa9f46
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发表时间：
2018-02-01
影响因子：
3.2
通讯作者：
Robertson AM
中科院分区：
文献类型：
--
作者：
Durka MJ;Wong IH;Kallmes DF;Pasalic D;Mut F;Jagani M;Blanco PJ;Cebral JR;Robertson AM
血流波形-血液动力学建模的基本数据-在实践中往往是不可用的研究人员。这项工作的目的是评估临床相关老年人群波形之间的变异性，并开发基于数据的方法来解决血流动力学研究中缺失的波形数据。我们分析了患有中度心血管疾病的老年患者（73±13岁）颈内动脉的272个血流波形，并使用这些数据开发方法来指导血流动力学研究的新方法。在老年人群中发现了波形参数的显著变化，而在已发表的年轻受试者数据中未发现。与年轻人相比，老年人群的共同特征包括收缩期与舒张期流速比较大、收缩晚期血流增加和无重搏切迹。确定了8个波形，共同代表了老年人群的波形范围。获得波形形状和流速之间的关系，结合将流速与直径相关的方程，可以用于为患者特定的几何形状提供个性化的波形。男性和女性患者的流速对直径的依赖性有统计学差异。结果表明，一个单一的原型波形不能很好地代表不同的波形中发现的老年人口，虽然这种方法是经常使用的脑血管系统中的流量的研究。受这些结果的启发，我们提供了一组8个波形，可用于评估与缺乏患者特定波形数据相关的血流动力学不确定性。我们还提供了一种方法，用于在已知患者性别、年龄和心血管疾病状态时生成个性化波形。这些数据驱动的方法可用于为老年患者设计更相关的体外或计算机模拟颅内血流动力学研究。
Blood flow waveforms - essential data for hemodynamic modeling - are often in practice unavailable to researchers. The objectives of this work were to assess the variability among the waveforms for a clinically relevant older population, and develop data-based methods for addressing the missing waveform data for hemodynamic studies. We analyzed 272 flow waveforms from the internal carotid arteries of older patients (73±13 years) with moderate cardiovascular disease, and used these data to develop methods to guide new approaches for hemodynamic studies. Profound variations in waveform parameters were found within the aged population that were not seen in published data for young subjects. Common features in the aged population relative to the young included a larger systole- to - diastole flow rate ratio, increased flow during late systole, and absence of a dicrotic notch. Eight waveforms were identified that collectively represent the range of waveforms in the older population. A relationship between waveform shape and flow rate was obtained that, in conjunction with equations relating flow rate to diameter, can be used to provide individualized waveforms for patient specific geometries. The dependence of flow rate on diameter was statistically different between male and female patients. It was shown that a single archetypal waveform cannot well-represent the diverse waveforms found within an aged population, although this approach is frequently used in studies of flow in the cerebral vasculature. Motivated by these results, we provided a set of eight waveforms that can be used to assess the hemodynamic uncertainty associated with the lack of patient specific waveform data. We also provided a methodology for generating individualized waveforms when patient gender, age, and cardiovascular disease state are known. These data driven approaches can be used to devise more relevant in-vitro or in-silico intra-cranial hemodynamic studies for older patients.
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影响因子：
8.3
作者：
Shojima, M;Oshima, M;Kirino, T
通讯作者：
Kirino, T
影响因子：
5
作者：
KALLMAN, CE;GOSINK, BB;GARDNER, DJ
通讯作者：
GARDNER, DJ
影响因子：
11
作者：
de Rooij, N. K.;Linn, F. H. H.;Rinkel, G. J. E.
通讯作者：
Rinkel, G. J. E.
影响因子：
3.7
作者：
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通讯作者：
Tarbell JM
影响因子：
5
作者：
OBoyle, MK;Vibhakar, NI;Gosink, BB
通讯作者：
Gosink, BB