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Du S, Yao Y, Sun G, Wang L, Alastruey J, Avolio AP, Xu L. Personalized aortic pressure waveform estimation from brachial pressure waveform using an adaptive transfer function. Comput Biol Med 2023; 155:106654. [PMID: 36791548 DOI: 10.1016/j.compbiomed.2023.106654] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 01/16/2023] [Accepted: 02/08/2023] [Indexed: 02/12/2023]
Abstract
BACKGROUND AND OBJECTIVE The aortic pressure waveform (APW) provides reliable information for the diagnosis of cardiovascular disease. APW is often measured using a generalized transfer function (GTF) applied to the peripheral pressure waveform acquired noninvasively, to avoid the significant risks of invasive APW acquisition. However, the GTF ignores various physiological conditions, which affects the accuracy of the estimated APW. To solve this problem, this study utilized an adaptive transfer function (ATF) combined with a tube-load model to achieve personalized and accurate estimation of APW from the brachial pressure waveform (BPW). METHODS The proposed method was validated using APWs and BPWs from 34 patients. The ATF was defined using a tube-load model in which pulse transit time and reflection coefficients were determined from, respectively, the diastolic-exponential-pressure-decay of the APW and a piece-wise constant approximation. The root-mean-square-error of overall morphology, mean absolute errors of common hemodynamic indices (systolic blood pressure, diastolic blood pressure and pulse pressure) were used to evaluate the ATF. RESULTS The proposed ATF performed better in estimating diastolic blood pressure and pulse pressure (1.63 versus 1.94 mmHg, and 2.37 versus 3.10 mmHg, respectively, both P < 0.10), and produced similar errors in overall morphology and systolic blood pressure (3.91 versus 4.24 mmHg, and 2.83 versus 2.91 mmHg, respectively, both P > 0.10) compared to GTF. CONCLUSION Unlike the GTF which uses fixed parameters trained on existing clinical datasets, the proposed method can achieve personalized estimation of APW. Hence, it provides accurate pulsatile hemodynamic measures for the evaluation of cardiovascular function.
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Affiliation(s)
- Shuo Du
- College of Medicine and Biological Information Engineering, Northeastern University, Shenyang, 110169, Liaoning, China
| | - Yang Yao
- College of Medicine and Biological Information Engineering, Northeastern University, Shenyang, 110169, Liaoning, China
| | - Guozhe Sun
- Department of Cardiology, The First Hospital of China Medical University, Shenyang, 110122, Liaoning, China
| | - Lu Wang
- School of Computer Science and Engineering, Northeastern University, Shenyang, 110169, China
| | - Jordi Alastruey
- Department of Biomedical Engineering, King's College, London, SE1 7EH, United Kingdom
| | - Alberto P Avolio
- Macquarie School of Medicine, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia
| | - Lisheng Xu
- College of Medicine and Biological Information Engineering, Northeastern University, Shenyang, 110169, Liaoning, China; Neusoft Research of Intelligent Healthcare Technology, Co. Ltd, Shenyang, 110169, Liaoning, China.
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Xiao H, Liu D, Avolio AP, Chen K, Li D, Hu B, Butlin M. Estimation of cardiac stroke volume from radial pulse waveform by artificial neural network. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2022; 218:106738. [PMID: 35303487 DOI: 10.1016/j.cmpb.2022.106738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Revised: 03/07/2022] [Accepted: 03/07/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND AND OBJECTIVES Stroke volume (SV) and cardiac output (CO) are the key indicators for the evaluation of cardiac function and hemodynamic status during the perioperative period, which are very important in the detection and treatment of cardiovascular diseases. Traditional CO and SV measurement methods have problems such as complex operation, low precision and poor generalization ability. METHODS In this paper, a method for estimating stroke volume based on cascade artificial neural network (ANN) and time domain features of radial pulse waveform (SVANN) was proposed. The simulation datasets of 4000 radial pulse waveforms and stroke volume (SVmeas) were generated by a 55 segment transmission line model of the human systemic vasculature and a recursive algorithm. The ANN was trained and tested by 10-fold cross-validation, and compared with 12 traditional models. RESULTS Experimental results showed that the Pearson correlation coefficients and mean difference between SVANN and SVmeas (R=0.95, mean standard deviation (SD) = 0.00 ± 6.45) were better than the best results of the 12 traditional models. Moreover, as increasing the number of training samples, the performance improvement of the ANN (R=0.94(Δ + 0.04), mean ± SD = 0.00 ± 6.38(Δ± 2.02)) was better than the other best model, namely, multiple linear regression model (MLR) (R=0.93(Δ + 0.03), mean ± SD = 0.00 ± 6.99(Δ± 1.50)). CONCLUSIONS A method is proposed to estimate cardiac stroke volume by the ANN with time domain features of radial pulse wave. It avoids the complicated modeling process based on hemodynamics within traditional models, improves the estimation accuracy of SV, and has a good generalization ability.
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Affiliation(s)
- Hanguang Xiao
- School of Artificial Intelligent, Chongqing University of Technology, Chongqing 400050, China.
| | - Daidai Liu
- School of Artificial Intelligent, Chongqing University of Technology, Chongqing 400050, China
| | - Alberto P Avolio
- Faculty of Medicine, Health and Human Sciences, Macquarie Medical School, NSW 2113, Australia
| | - Kai Chen
- School of Artificial Intelligent, Chongqing University of Technology, Chongqing 400050, China
| | - Decai Li
- SichuanMianyang 404 Hospital, Mianyang, Sichuan Province 400050, China
| | - Bo Hu
- SichuanMianyang 404 Hospital, Mianyang, Sichuan Province 400050, China
| | - Mark Butlin
- Faculty of Medicine, Health and Human Sciences, Macquarie Medical School, NSW 2113, Australia.
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Zhou Y, He Y, Wu J, Cui C, Chen M, Sun B. A method of parameter estimation for cardiovascular hemodynamics based on deep learning and its application to personalize a reduced-order model. INTERNATIONAL JOURNAL FOR NUMERICAL METHODS IN BIOMEDICAL ENGINEERING 2022; 38:e3533. [PMID: 34585523 DOI: 10.1002/cnm.3533] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 09/26/2021] [Indexed: 06/13/2023]
Abstract
Precise model personalization is a key step towards the application of cardiovascular physical models. In this manuscript, we propose to use deep learning (DL) to solve the parameter estimation problem in cardiovascular hemodynamics. Based on the convolutional neural network (CNN) and fully connected neural network (FCNN), a multi-input deep neural network (DNN) model is developed to map the nonlinear relationship between measurements and the parameters to be estimated. In this model, two separate network structures are designed to extract the features of two types of measurement data, including pressure waveforms and a vector composed of heart rate (HR) and pulse transit time (PTT), and a shared structure is used to extract their combined dependencies on the parameters. Besides, we try to use the transfer learning (TL) technology to further strengthen the personalized characteristics of a trained-well network. For assessing the proposed method, we conducted the parameter estimation using synthetic data and in vitro data respectively, and in the test with synthetic data, we evaluated the performance of the TL algorithm through two individuals with different characteristics. A series of estimation results show that the estimated parameters are in good agreement with the true values. Furthermore, it is also found that the estimation accuracy can be significantly improved by a multicycle combination strategy. Therefore, we think that the proposed method has the potential to be used for parameter estimation in cardiovascular hemodynamics, which can provide an immediate, accurate, and sustainable personalization process, and deserves more attention in the future.
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Affiliation(s)
- Yang Zhou
- School of Mechanical Engineering, Southeast University, Nanjing, China
| | - Yuan He
- Internal Medicine-Cardiovascular Department, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Jianwei Wu
- School of Mechanical Engineering, Southeast University, Nanjing, China
| | - Chang Cui
- Internal Medicine-Cardiovascular Department, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Minglong Chen
- Internal Medicine-Cardiovascular Department, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Beibei Sun
- School of Mechanical Engineering, Southeast University, Nanjing, China
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Liu W, Yao Y, Yang J, Song D, Zhang Y, Sun G, Xu L, Avolio A. Estimation of aortic pulse wave velocity based on waveform decomposition of central aortic pressure waveform. Physiol Meas 2021; 42. [PMID: 34479234 DOI: 10.1088/1361-6579/ac23a7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 09/03/2021] [Indexed: 12/21/2022]
Abstract
Objective.Aortic stiffness is associated with risk of cardiovascular events. Carotid-femoral pulse wave velocity (cfPWV) is the current noninvasive gold standard for assessing aortic stiffness. However, the cfPWV measurement is challenging, requiring simultaneous signals at the carotid and femoral sites.Approach.In this study, the aortic PWV is estimated using a single radial pressure waveform and compared with cfPWV. 111 subjects' aortic PWVs are estimated from the decomposition of the derived central aortic pressure waveform based on three types of reconstructed flow waveform: the peak of triangular flow waveform based on 30% ejection time (Q30%tri), the peak of triangular flow waveform based on inflection point (Qtri), and averaged flow waveform (Qavg). The central aortic pressure waveform is derived from a radial pressure waveform via a validated transfer function.Main results.TheQavgis used for estimating aortic PWV without the determination of the peak point of the triangular flow waveforms. The estimated aortic PWV shows good agreement with cfPWV. The mean difference ± SD is 0.29 ± 1.50 m s-1(r2 = 0.29,p< 0.001) for theQ30%tri; 0.27 ± 1.40 m s-1(r2 = 0.38,p < 0.001) for theQtri; 0.23 ± 1.39 m s-1(r2 = 0.40,p < 0.001) for theQavg. The correlation between estimated aortic PWV based onQ30%triand measured cfPWV is weak. The results ofQtriandQavgshow no obvious difference.Significance.The proposed method can be used as a less complex way than conventional measurement of cfPWV to further assess arterial stiffness and predict cardiovascular risks or events.
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Affiliation(s)
- Wenyan Liu
- College of Medicine and Biological and Information Engineering, Northeastern University, Shenyang 110167, People's Republic of China
| | - Yang Yao
- College of Medicine and Biological and Information Engineering, Northeastern University, Shenyang 110167, People's Republic of China
| | - Jinzhong Yang
- College of Medicine and Biological and Information Engineering, Northeastern University, Shenyang 110167, People's Republic of China
| | - Daiyuan Song
- College of Medicine and Biological and Information Engineering, Northeastern University, Shenyang 110167, People's Republic of China
| | - Yuelan Zhang
- Department of Cardiology, the First Hospital of China Medical University, Shenyang 110001, People's Republic of China
| | - Guozhe Sun
- Department of Cardiology, the First Hospital of China Medical University, Shenyang 110001, People's Republic of China
| | - Lisheng Xu
- College of Medicine and Biological and Information Engineering, Northeastern University, Shenyang 110167, People's Republic of China.,Neusoft Research of Intelligent Healthcare Technology, Co. Ltd Shenyang 110169, People's Republic of China
| | - Alberto Avolio
- Macquarie School of Medicine, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia
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The composition of vulnerable plaque and its effect on arterial waveforms. J Mech Behav Biomed Mater 2021; 119:104491. [PMID: 33901965 DOI: 10.1016/j.jmbbm.2021.104491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 02/21/2021] [Accepted: 03/19/2021] [Indexed: 11/22/2022]
Abstract
Carotid plaque composition is a key factor of plaque stability and it carries significant prognostic information. The carotid unstable plaques are characterized by a thin fibrous cap (FC) ≤65μm with large lipid core (LC), while stable plaques have a thicker FC and less LC. Identifying the percentage of plaque compositions could help surgeons to make a precise decision for their patients' treatment protocol. This study aims to distinguish between stable and unstable plaque by defining the relationship between plaque composition and arterial waveform non-invasively. An in-vitro arterial system, composed of a Harvard pulsatile flow pump and artificial circulation system, was used to investigate the effect of the plaque compositions on the pulsatile arterial waveforms. Five types of arterial plaques, composed of the LC, FC, Collagen (Col) and Calcium (Ca), were implemented into the artificial carotid artery to represent the diseased arterial system with 30% of blockage. The pulsatile pressure, velocity and arterial wall movement were measured simultaneously at the site proximal to the plaque. Non-invasive wave intensity analysis (Non-WIA) was used to separate the waves into forward and backward components. The correlation between the plaque compositions and the reflected waveforms was quantitatively analysed. The experimental results indicate that the reflected waveforms are strongly correlated with the plaque compositions, where the percentages of the Col are linearly correlated with the amplitude of the backward diameter (correlation coefficient, r = 0.74) and the lipid content has a strong negative correlation with the backward diameter (r = 0.82). A slight weak correlation exists between the reflected waveform and the percentage of Ca. The strong correlation between the compositions of the plaques with the backward waveforms observed in this study demonstrates that the components of the arterial plaques could be distinguished by the arterial waveforms. This finding might lead to a potential novel non-invasive clinical tool to determine the composition of the plaques and distinguish between stable and vulnerable arterial plaques at the early stage.
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