TY - JOUR
T1 - Novel Pressure Wave Separation Analysis for Cardiovascular Function Assessment Highlights Major Role of Aortic Root
AU - Vennin, Samuel
AU - Li, Ye
AU - Mariscal Harana, Jorge
AU - Charlton, Peter
AU - Fok, Henry
AU - Gu, Haotian
AU - Chowienczyk, Philip
AU - Alastruey, Jordi
N1 - Publisher Copyright:
Author
PY - 2021/11/12
Y1 - 2021/11/12
N2 - Objective: A novel method was presented to separate the central blood pressure wave (CBPW) into five components with different biophysical and temporal origins. It includes a time-varying emission coefficient () that quantifies pulse wave generation and reflection at the aortic root. Methods: The method was applied to normotensive subjects with modulated physiology by inotropic/vasoactive drugs (n=13), hypertensive subjects (n=158), and virtual subjects (n=4,374). Results: is directly proportional to aortic flow throughout the cardiac cycle. Mean peak increased with increasing pulse pressure (from <30 to >70 mmHg) in the hypertensive (from 1.6 to 2.5, P<0.001) and in silico (from 1.4 to 2.8, P<0.001) groups, dobutamine dose (from baseline to 7.5 g/kg/min) in the normotensive group (from 2.1 to 2.7, P<0.05), and remained unchanged when peripheral wave reflections were suppressed in silico. This was accompanied by an increase in the percentage contribution of the cardiac-aortic-coupling component of CBPW in systole: from 11% to 23% (P<0.001) in the hypertensive group, 9% to 21% (P<0.001) in the in silico group, and 17% to 23% (P<0.01) in the normotensive group. Conclusion: These results suggest that the aortic root is a major reflection site in the systemic arterial network and ventricular-aortic coupling is the main determinant in the elevation of pulsatile pulse pressure. Significance: Ventricular-aortic coupling is a prime therapeutic target for preventing/treating systolic hypertension.
AB - Objective: A novel method was presented to separate the central blood pressure wave (CBPW) into five components with different biophysical and temporal origins. It includes a time-varying emission coefficient () that quantifies pulse wave generation and reflection at the aortic root. Methods: The method was applied to normotensive subjects with modulated physiology by inotropic/vasoactive drugs (n=13), hypertensive subjects (n=158), and virtual subjects (n=4,374). Results: is directly proportional to aortic flow throughout the cardiac cycle. Mean peak increased with increasing pulse pressure (from <30 to >70 mmHg) in the hypertensive (from 1.6 to 2.5, P<0.001) and in silico (from 1.4 to 2.8, P<0.001) groups, dobutamine dose (from baseline to 7.5 g/kg/min) in the normotensive group (from 2.1 to 2.7, P<0.05), and remained unchanged when peripheral wave reflections were suppressed in silico. This was accompanied by an increase in the percentage contribution of the cardiac-aortic-coupling component of CBPW in systole: from 11% to 23% (P<0.001) in the hypertensive group, 9% to 21% (P<0.001) in the in silico group, and 17% to 23% (P<0.01) in the normotensive group. Conclusion: These results suggest that the aortic root is a major reflection site in the systemic arterial network and ventricular-aortic coupling is the main determinant in the elevation of pulsatile pulse pressure. Significance: Ventricular-aortic coupling is a prime therapeutic target for preventing/treating systolic hypertension.
UR - http://www.scopus.com/inward/record.url?scp=85119003525&partnerID=8YFLogxK
U2 - 10.1109/TBME.2021.3127799
DO - 10.1109/TBME.2021.3127799
M3 - Article
C2 - 34767501
SN - 0018-9294
VL - PP
JO - IEEE Transactions on Biomedical Engineering
JF - IEEE Transactions on Biomedical Engineering
ER -