A database of virtual healthy subjects
to assess the accuracy of foot-to-foot pulse wave velocities for estimation of aortic stiffness

TY - JOUR

T1 - A database of virtual healthy subjects
to assess the accuracy of foot-to-foot pulse wave velocities for estimation of aortic stiffness

AU - Willemet, Marie Cecile

AU - Chowienczyk, Philip Jan

AU - Alastruey, Jordi

PY - 2015/8/15

Y1 - 2015/8/15

N2 - 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, carotid-radial) are being studied as substitutes of this central measurement. We present a novel methodology to assess theoretically these computed indices and the hemodynamics mechanisms relating them. We created a database of 3320 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 were computed from numerical pressure waveforms at the same locations where clinical measurements are commonly taken. Our numerical results confirm clinical observations: (i) carotid-femoral PWV is a good indicator of aortic stiffness, and correlates well with aortic PWV; (ii) brachial-ankle PWV over-estimates aortic PWV and is related to the stiffness and geometry of both elastic and muscular arteries; (iii) muscular PWV (carotid-radial, femoral-ankle) do 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 indices based on pulse wave analysis.

AB - 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, carotid-radial) are being studied as substitutes of this central measurement. We present a novel methodology to assess theoretically these computed indices and the hemodynamics mechanisms relating them. We created a database of 3320 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 were computed from numerical pressure waveforms at the same locations where clinical measurements are commonly taken. Our numerical results confirm clinical observations: (i) carotid-femoral PWV is a good indicator of aortic stiffness, and correlates well with aortic PWV; (ii) brachial-ankle PWV over-estimates aortic PWV and is related to the stiffness and geometry of both elastic and muscular arteries; (iii) muscular PWV (carotid-radial, femoral-ankle) do 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 indices based on pulse wave analysis.

KW - brachial-ankle PWV

KW - carotid-femoral PWV

KW - numerical 1D model

KW - aortic stiffness

KW - database of virtual subjects

U2 - 10.1152/ajpheart.00175.2015

DO - 10.1152/ajpheart.00175.2015

M3 - Article

SN - 0363-6135

VL - 309

SP - H663–H675

JO - AMERICAN JOURNAL OF PHYSIOLOGY-HEART AND CIRCULATORY PHYSIOLOGY

JF - AMERICAN JOURNAL OF PHYSIOLOGY-HEART AND CIRCULATORY PHYSIOLOGY

IS - 4

ER -