Estimating Central Pulse Pressure From Blood Flow by Identifying the Main Physical Determinants of Pulse Pressure Amplification
Por:
Flores Geronimo, Joaquin, Corvera Poire, Eugenia, Chowienczyk, Philip, Alastruey, Jordi
Publicada:
23 feb 2021
Resumen:
Several studies suggest that central (aortic) blood pressure (cBP) is a
better marker of cardiovascular disease risk than peripheral blood
pressure (pBP). The morphology of the pBP wave, usually assessed
non-invasively in the arm, differs significantly from the cBP wave,
whose direct measurement is highly invasive. In particular, pulse
pressure, PP (the amplitude of the pressure wave), increases from
central to peripheral arteries, leading to the so-called pulse pressure
amplification (Delta PP). The main purpose of this study was to develop
a methodology for estimating central PP (cPP) from non-invasive
measurements of aortic flow and peripheral PP. Our novel approach is
based on a comprehensive understanding of the main cardiovascular
properties that determine Delta PP along the aortic-brachial arterial
path, namely brachial flow wave morphology in late systole, and vessel
radius and distance along this arterial path. This understanding was
achieved by using a blood flow model which allows for workable
analytical solutions in the frequency domain that can be decoupled and
simplified for each arterial segment. Results show the ability of our
methodology to (i) capture changes in cPP and Delta PP produced by
variations in cardiovascular properties and (ii) estimate cPP with mean
differences smaller than 3.3 +/- 2.8 mmHg on in silico data for
different age groups (25-75 years old) and 5.1 +/- 6.9 mmHg on in vivo
data for normotensive and hypertensive subjects. Our approach could
improve cardiovascular function assessment in clinical cohorts for which
aortic flow wave data is available.
Filiaciones:
Flores Geronimo, Joaquin:
Kings Coll London, Dept Biomed Engn, Sch Biomed Engn & Imaging Sci, London, England
Corvera Poire, Eugenia:
Univ Nacl Autonoma Mexico, Dept Fis & Quim Teor, Fac Quim, Ciudad Univ, Mexico City, DF, Mexico
Univ Barcelona, Univ Barcelona Inst Complex Syst UBICS, Barcelona, Spain
Chowienczyk, Philip:
Kings Coll London, Dept Clin Pharmacol, British Heart Fdn Ctr, St Thomas Hosp, London, England
Alastruey, Jordi:
Kings Coll London, Dept Biomed Engn, Sch Biomed Engn & Imaging Sci, London, England
Sechenov Univ, Digital Biodesign & Personalized Healthcare, World Class Res Ctr, Moscow, Russia
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