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Zhang X, Wang Y, Yin Z, Liang F. Optimization and validation of a suprasystolic brachial cuff-based method for noninvasively estimating central aortic blood pressure. INTERNATIONAL JOURNAL FOR NUMERICAL METHODS IN BIOMEDICAL ENGINEERING 2024; 40:e3806. [PMID: 38281742 DOI: 10.1002/cnm.3806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 12/12/2023] [Accepted: 01/14/2024] [Indexed: 01/30/2024]
Abstract
Clinical studies have extensively demonstrated that central aortic blood pressure (CABP) has greater clinical significance in comparison with peripheral blood pressure. Despite the existence of various techniques for noninvasively measuring CABP, the clinical applications of most techniques are hampered by the unsatisfactory accuracy or large variability in measurement errors. In this study, we proposed a new method for noninvasively estimating CABP with improved accuracy and reduced uncertain errors. The main idea was to optimize the estimation of the pulse wave transit time from the aorta to the occluded lumen of the brachial artery under a suprasystolic cuff by identifying and utilizing the characteristic information of the cuff oscillation wave, thereby improving the accuracy and stability of the CABP estimation algorithms under various physiological conditions. The method was firstly developed and verified based on large-scale virtual subject data (n = 800) generated by a computational model of the cardiovascular system coupled to a brachial cuff, and then validated with small-scale in vivo data (n = 34). The estimation errors for the aortic systolic pressure were -0.05 ± 0.63 mmHg in the test group of the virtual subjects and -1.09 ± 3.70 mmHg in the test group of the patients, both demonstrating a good performance. In particular, the estimation errors were found to be insensitive to variations in hemodynamic conditions and cardiovascular properties, manifesting the high robustness of the method. The method may have promising clinical applicability, although further validation studies with larger-scale clinical data remain necessary.
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Affiliation(s)
- Xujie Zhang
- Department of Engineering Mechanics, School of Naval Architecture, Ocean & Civil Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Yue Wang
- Department of Cardiology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhaofang Yin
- Department of Cardiology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Fuyou Liang
- Department of Engineering Mechanics, School of Naval Architecture, Ocean & Civil Engineering, Shanghai Jiao Tong University, Shanghai, China
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2
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Xiao H, Song W, Liu C, Peng B, Zhu M, Jiang B, Liu Z. Reconstruction of central arterial pressure waveform based on CBi-SAN network from radial pressure waveform. Artif Intell Med 2023; 145:102683. [PMID: 37925212 DOI: 10.1016/j.artmed.2023.102683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Revised: 05/30/2023] [Accepted: 10/06/2023] [Indexed: 11/06/2023]
Abstract
The central arterial pressure (CAP) is an important physiological indicator of the human cardiovascular system which represents one of the greatest threats to human health. Accurate non-invasive detection and reconstruction of CAP waveforms are crucial for the reliable treatment of cardiovascular system diseases. However, the traditional methods are reconstructed with relatively low accuracy, and some deep learning neural network models also have difficulty in extracting features, as a result, these methods have potential for further advancement. In this study, we proposed a novel model (CBi-SAN) to implement an end-to-end relationship from radial artery pressure (RAP) waveform to CAP waveform, which consisted of the convolutional neural network (CNN), the bidirectional long-short-time memory network (BiLSTM), and the self-attention mechanism to improve the performance of CAP reconstruction. The data on invasive measurements of CAP and RAP waveform were used in 62 patients before and after medication to develop and validate the performance of CBi-SAN model for reconstructing CAP waveform. We compared it with traditional methods and deep learning models in mean absolute error (MAE), root mean square error (RMSE), and Spearman correlation coefficient (SCC). Study results indicated the CBi-SAN model performed great performance on CAP waveform reconstruction (MAE: 2.23 ± 0.11 mmHg, RMSE: 2.21 ± 0.07 mmHg), concurrently, the best reconstruction effect was obtained in the central artery systolic pressure (CASP) and the central artery diastolic pressure(CADP) (RMSECASP: 2.94 ± 0.48 mmHg, RMSECADP: 1.96 ± 0.06 mmHg). These results implied the performance of the CAP reconstruction based on CBi-SAN model was superior to the existing methods, hopped to be effectively applied to clinical practice in the future.
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Affiliation(s)
- Hanguang Xiao
- College of Artificial Intelligent, Chongqing University of Technology, Chongqing 401135, China.
| | - Wangwang Song
- College of Artificial Intelligent, Chongqing University of Technology, Chongqing 401135, China
| | - Chang Liu
- College of Artificial Intelligent, Chongqing University of Technology, Chongqing 401135, China
| | - Bo Peng
- College of Artificial Intelligent, Chongqing University of Technology, Chongqing 401135, China
| | - Mi Zhu
- College of Artificial Intelligent, Chongqing University of Technology, Chongqing 401135, China
| | - Bin Jiang
- College of Artificial Intelligent, Chongqing University of Technology, Chongqing 401135, China
| | - Zhi Liu
- College of Artificial Intelligent, Chongqing University of Technology, Chongqing 401135, China.
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3
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Climie RE, Alastruey J, Mayer CC, Schwarz A, Laucyte-Cibulskiene A, Voicehovska J, Bianchini E, Bruno RM, Charlton PH, Grillo A, Guala A, Hallab M, Hametner B, Jankowski P, Königstein K, Lebedeva A, Mozos I, Pucci G, Puzantian H, Terentes-Printzios D, Yetik-Anacak G, Park C, Nilsson PM, Weber T. Vascular ageing: moving from bench towards bedside. Eur J Prev Cardiol 2023; 30:1101-1117. [PMID: 36738307 PMCID: PMC7614971 DOI: 10.1093/eurjpc/zwad028] [Citation(s) in RCA: 23] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 12/20/2022] [Accepted: 01/12/2023] [Indexed: 02/05/2023]
Abstract
Prevention of cardiovascular disease (CVD) remains one of the largest public health challenges of our time. Identifying individuals at increased cardiovascular risk at an asymptomatic, sub-clinical stage is of paramount importance for minimizing disease progression as well as the substantial health and economic burden associated with overt CVD. Vascular ageing (VA) involves the deterioration in vascular structure and function over time and ultimately leads to damage in the heart, brain, kidney, and other organs. Vascular ageing encompasses the cumulative effect of all cardiovascular risk factors on the arterial wall over the life course and thus may help identify those at elevated cardiovascular risk, early in disease development. Although the concept of VA is gaining interest clinically, it is seldom measured in routine clinical practice due to lack of consensus on how to characterize VA as physiological vs. pathological and various practical issues. In this state-of-the-art review and as a network of scientists, clinicians, engineers, and industry partners with expertise in VA, we address six questions related to VA in an attempt to increase knowledge among the broader medical community and move the routine measurement of VA a little closer from bench towards bedside.
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Affiliation(s)
- Rachel E. Climie
- Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool St, 7000 Hobart, Australia
- Sports Cardiology, Baker Heart and Diabetes Institute, 99 Commercial Rd, Melbourne 3000, Australia
- Integrative Epidemiology of Cardiovascular Disease, Université de Paris, INSERM, U970, Paris Cardiovascular Research Center (PARCC), 56 rue Leblanc, 75015 Paris, France
| | - Jordi Alastruey
- Department of Biomedical Engineering, School of Biomedical Engineering and Imaging Sciences, King’s College London, 249 Westminster Bridge Rd, London SE1 7EH, UK
| | - Christopher C. Mayer
- Medical Signal Analysis, Center for Health & Bioresources, AIT Austrian Institute of Technology, Giefinggasse 4, 1210 Vienna, Austria
| | - Achim Schwarz
- ALF Distribution GmbH, Stephanstrasse 19, 52064 Aachen, Germany
| | - Agne Laucyte-Cibulskiene
- Department of Clinical Sciences, Lund University, Skane University Hospital, Sölvegatan 19 - BMC F12, 221 84 Lund, Malmö, Sweden
- Faculty of Medicine, Vilnius University, M. K. C iurlionio g. 21, 03101 Vilnius, Lithuania
| | - Julija Voicehovska
- Department of Internal Diseases, Riga Stradins University, Dzirciema str. 16, Riga, L-1007, Latvia
- Nephrology and Renal Replacement Therapy Clinics, Riga East University Hospital, Hipokrata str. 2, Riga, LV-1079, Latvia
| | - Elisabetta Bianchini
- Institute of Clinical Physiology, Italian National Research Council (CNR), Via Moruzzi, 1, 56124 Pisa (PI), Italy
| | - Rosa-Maria Bruno
- Integrative Epidemiology of Cardiovascular Disease, Université de Paris, INSERM, U970, Paris Cardiovascular Research Center (PARCC), 56 rue Leblanc, 75015 Paris, France
| | - Peter H. Charlton
- Department of Public Health and Primary Care, University of Cambridge, Strangeways Research Laboratory, 2 Worts Causeway, Cambridge CB1 8RN, UK
| | - Andrea Grillo
- Medicina Clinica, Department of Medicine, Surgery and Health Sciences, University of Trieste, Strada di Fiume 447, 34149 Trieste, Italy
| | - Andrea Guala
- Vall d’Hebron Institut de Recerca (VHIR), Paseo de la Vall d’Hebron, 129, 08035 Barcelona, Spain
| | - Magid Hallab
- Clinique Bizet, 23 Georges Bizet, 75116 Paris, France
| | - Bernhard Hametner
- Medical Signal Analysis, Center for Health & Bioresources, AIT Austrian Institute of Technology, Giefinggasse 4, 1210 Vienna, Austria
| | - Piotr Jankowski
- Department of Internal Medicine and Geriatric Cardiology, Centre of Postgraduate Medical Education, 231 Czerniakowska St., 00-416 Warsaw, Poland
| | - Karsten Königstein
- Department of Sport, Exercise and Health (DSBG) University of Basel, Grosse Allee 6, 4052 Basel, Switzerland
| | - Anna Lebedeva
- Department of Internal Medicine and Cardiology, Dresden Heart Centre, Dresden University of Technology, Fetscher str. 76, 01307 Dresden, Germany
| | - Ioana Mozos
- Department of Functional Sciences-Pathophysiology, Center for Translational Research and Systems Medicine, ‘Victor Babes’ University of Medicine and Pharmacy, T. Vladimirescu Street 14, 300173 Timisoara, Romania
| | - Giacomo Pucci
- Unit of Internal Medicine, Terni University Hospital - Department of Medicine and Surgery, University of Perugia, Terni, Italy
| | - Houry Puzantian
- Hariri School of Nursing, American University of Beirut, P.O. Box 11-0236, Riad El Solh 1107 2020, Beirut, Lebanon
| | - Dimitrios Terentes-Printzios
- First Department of Cardiology, Hippokration Hospital, Medical School, National and Kapodistrian University of Athens, 114 Vasilissis Sofias Avenue, 11527 Athens, Greece
| | - Gunay Yetik-Anacak
- Department of Pharmacology, Faculty of Pharmacy, Acibadem Mehmet Ali Aydinlar University, Kayisdagi Cad. No:32 Atasehir, 34752 Istanbul, Turkey
| | - Chloe Park
- MRC Unit for Lifelong Health and Ageing at UCL, 1-19 Torrington Place, London WC1E 7HB, UK; and
| | - Peter M. Nilsson
- Department of Clinical Sciences, Lund University, Skane University Hospital, Sölvegatan 19 - BMC F12, 221 84 Lund, Malmö, Sweden
| | - Thomas Weber
- Cardiology Department, Klinikum Wels-Grieskirchen, Grieskirchnerstrasse 42, 4600 Wels, Austria
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Guala A, Gil-Sala D, Garcia Reyes ME, Azancot MA, Dux-Santoy L, Allegue Allegue N, Teixido-Turà G, Goncalves Martins G, Galian-Gay L, Garrido-Oliver J, Constenla García I, Evangelista A, Tello Díaz C, Carrasco-Poves A, Morales-Galán A, Ferreira-González I, Rodríguez-Palomares J, Bellmunt Montoya S. Impact of thoracic endovascular aortic repair following blunt traumatic thoracic aortic injury on blood pressure. J Thorac Cardiovasc Surg 2023:S0022-5223(23)00623-2. [PMID: 37490995 DOI: 10.1016/j.jtcvs.2023.07.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 06/16/2023] [Accepted: 07/02/2023] [Indexed: 07/27/2023]
Abstract
BACKGROUND Blunt traumatic thoracic aortic injuries (BTAIs) are associated with a high mortality rate. Thoracic endovascular aortic repair (TEVAR) is the most frequently used surgical strategy in patients with BTAI, as it offers good short- and middle-term results. Previous studies have reported an abnormally high prevalence of hypertension (HT) in these patients. This work aimed to describe the long-term prevalence of HT and provide a comprehensive evaluation of the biomechanical, clinical, and functional factors involved in HT development. METHODS Twenty-six patients treated with TEVAR following BTAI with no history of HT at the time of trauma were enrolled. They were matched with 37 healthy volunteers based on age, sex, and body surface area and underwent a comprehensive follow-up study, including cardiovascular magnetic resonance, 24-hour ambulatory blood pressure monitoring, and assessment of carotid-femoral pulse wave velocity (cfPWV, a measure of aortic stiffness) and flow-mediated vasodilation. RESULTS The mean patient age was 43.5 ± 12.9 years, and the majority were male (23 of 26; 88.5%). At a mean of 120.2 ± 69.7 months after intervention, 17 patients (65%) presented with HT, 14 (54%) had abnormal nighttime blood pressure dipping, and 6 (23%) high cfPWV. New-onset HT was related to a more proximal TEVAR landing zone and greater distal oversizing. Abnormal nighttime blood pressure was related to high cfPWV, which in turn was associated with TEVAR length and premature arterial aging. CONCLUSIONS HT frequently occurs otherwise healthy subjects undergoing TEVAR implantation after BTAI. TEVAR stiffness and length, the proximal landing zone, and distal oversizing are potentially modifiable surgical characteristics related to abnormal blood pressure.
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Affiliation(s)
- Andrea Guala
- Vall d'Hebron Institut de Recerca, Barcelona, Spain; CIBER-CV, Instituto de Salud Carlos III, Madrid, Spain.
| | - Daniel Gil-Sala
- Vascular and Endovascular Surgery, Institut Clínic Cardiovascular, Hospital Clínic, Barcelona, Spain; Department of Surgery, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Marvin E Garcia Reyes
- Vascular and Endovascular Surgery, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Maria A Azancot
- Department of Nephrology, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | | | | | - Gisela Teixido-Turà
- Vall d'Hebron Institut de Recerca, Barcelona, Spain; CIBER-CV, Instituto de Salud Carlos III, Madrid, Spain; Department of Cardiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | | | - Laura Galian-Gay
- Vall d'Hebron Institut de Recerca, Barcelona, Spain; Department of Cardiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | | | - Ivan Constenla García
- Vascular and Endovascular Surgery, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Arturo Evangelista
- Vall d'Hebron Institut de Recerca, Barcelona, Spain; CIBER-CV, Instituto de Salud Carlos III, Madrid, Spain; Department of Cardiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Heart Institute, Quirónsalud-Teknon, Barcelona, Spain
| | - Cristina Tello Díaz
- Vascular and Endovascular Surgery, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | | | | | - Ignacio Ferreira-González
- Vall d'Hebron Institut de Recerca, Barcelona, Spain; Department of Cardiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Center for Biomedical Research in Epidemiology and Public Health Network (CIBER-ESP), Instituto de Salud Carlos III, Madrid, Spain; Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Jose Rodríguez-Palomares
- Vall d'Hebron Institut de Recerca, Barcelona, Spain; CIBER-CV, Instituto de Salud Carlos III, Madrid, Spain; Department of Cardiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Universitat Autònoma de Barcelona, Bellaterra, Spain.
| | - Sergi Bellmunt Montoya
- Vall d'Hebron Institut de Recerca, Barcelona, Spain; Department of Surgery, Universitat Autònoma de Barcelona, Bellaterra, Spain; Vascular and Endovascular Surgery, Hospital Universitari Vall d'Hebron, Barcelona, Spain
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5
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Bianchini E, Lønnebakken MT, Wohlfahrt P, Piskin S, Terentes‐Printzios D, Alastruey J, Guala A. Magnetic Resonance Imaging and Computed Tomography for the Noninvasive Assessment of Arterial Aging: A Review by the VascAgeNet COST Action. J Am Heart Assoc 2023; 12:e027414. [PMID: 37183857 PMCID: PMC10227315 DOI: 10.1161/jaha.122.027414] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
Magnetic resonance imaging and computed tomography allow the characterization of arterial state and function with high confidence and thus play a key role in the understanding of arterial aging and its translation into the clinic. Decades of research into the development of innovative imaging sequences and image analysis techniques have led to the identification of a large number of potential biomarkers, some bringing improvement in basic science, others in clinical practice. Nonetheless, the complexity of some of these biomarkers and the image analysis techniques required for their computation hamper their widespread use. In this narrative review, current biomarkers related to aging of the aorta, their founding principles, the sequence, and postprocessing required, and their predictive values for cardiovascular events are summarized. For each biomarker a summary of reference values and reproducibility studies and limitations is provided. The present review, developed in the COST Action VascAgeNet, aims to guide clinicians and technical researchers in the critical understanding of the possibilities offered by these advanced imaging modalities for studying the state and function of the aorta, and their possible clinically relevant relationships with aging.
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Affiliation(s)
| | - Mai Tone Lønnebakken
- Department of Clinical ScienceUniversity of BergenBergenNorway
- Department of Heart DiseaseHaukeland University HospitalBergenNorway
| | - Peter Wohlfahrt
- Department of Preventive CardiologyInstitute for Clinical and Experimental MedicinePragueCzech Republic
- Centre for Cardiovascular PreventionCharles University Medical School I and Thomayer HospitalPragueCzech Republic
- Department of Medicine IICharles University in Prague, First Faculty of MedicinePragueCzech Republic
| | - Senol Piskin
- Department of Mechanical Engineering, Faculty of Engineering and Natural SciencesIstinye UniversityIstanbulTurkey
- Modeling, Simulation and Extended Reality LaboratoryIstinye UniversityIstanbulTurkey
| | - Dimitrios Terentes‐Printzios
- First Department of Cardiology, Hippokration Hospital, Athens Medical SchoolNational and Kapodistrian University of AthensGreece
| | - Jordi Alastruey
- School of Biomedical Engineering and Imaging SciencesKing’s College LondonLondonUK
| | - Andrea Guala
- Vall d’Hebron Institut de Recerca (VHIR)BarcelonaSpain
- CIBER‐CV, Instituto de Salud Carlos IIIMadridSpain
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6
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Liu J, Huang S, Wang X, Li B, Ma J, Sun Y, Liu J, Liu Y. On inlet pressure boundary conditions for CT-based computation of fractional flow reserve: clinical measurement of aortic pressure. Comput Methods Biomech Biomed Engin 2023; 26:517-526. [PMID: 35583353 DOI: 10.1080/10255842.2022.2072172] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND AND OBJECTIVES A quick calculation approach of steady-state fractional flow reserve (FFRss) based on computed tomography angiography (CTA) images is a reliable non-invasive way of calculate FFR, the assumptions used in the research should be study further to increase forecast accuracy. The effect of inlet and outlet boundary conditions on FFRss was investigated. METHODS 15 patients who had been diagnosed with coronary artery disease were enrolled in this study. We investigated the sensitivity of calculating FFR to boundary circumstances, using invasive FFR as a benchmark. There are two types of inlet: (1) aortic pressure based on clinically measured. (2) mean pressure calculated based on physiological formula; we further studied the outlet changes of FFRss under different coronary vasodilation responses (24%, 48%, 72%). RESULTS According to the calculate FFR results of all patients, FFRSST (based on the clinical experiment) and FFRSSM (based on the physiological formula) {r = 0.99, [95% confidence interval (CI):0.0.94 to 1.14] (p < 0.001)}. Although the pressure difference between the two pressure boundary conditions is 15 mmHg, the calculated FFR result does not change significantly. The microcirculation resistance of the outlet gradually rose as the vasodilation state changed, and the computed FFR increased. CONCLUSIONS A numerical analysis of the effects of proximal and distal boundary constraints of computational models on computed CT-FFR is presented. The findings revealed that distal boundary circumstances (hyperemic vasodilation response of coronary micro-vessels) have a significant impact on FFR, providing evidence to guide the development and application of a computational model for estimating FFR.
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Affiliation(s)
- Jincheng Liu
- Faculty of Environment and Life, Beijing University of Technology, Beijing 100124, China
| | - Suqin Huang
- Faculty of Environment and Life, Beijing University of Technology, Beijing 100124, China
| | - Xue Wang
- Faculty of Environment and Life, Beijing University of Technology, Beijing 100124, China
| | - Bao Li
- Faculty of Environment and Life, Beijing University of Technology, Beijing 100124, China
| | - Junling Ma
- Faculty of Environment and Life, Beijing University of Technology, Beijing 100124, China
| | - Yutong Sun
- Cardiovascular Department, Peking University People's Hospital, Peking University, Beijing 100029, China
| | - Jian Liu
- Cardiovascular Department, Peking University People's Hospital, Peking University, Beijing 100029, China
| | - Youjun Liu
- Faculty of Environment and Life, Beijing University of Technology, Beijing 100124, China
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7
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Murphy L, Chase JG. Single measurement estimation of central blood pressure using an arterial transfer function. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2023; 229:107254. [PMID: 36459818 DOI: 10.1016/j.cmpb.2022.107254] [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: 08/04/2022] [Revised: 11/16/2022] [Accepted: 11/17/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Central blood pressure (BP) better reflects the loading conditions on the major organs and is more closely correlated with future cardiovascular events. The increased invasiveness and risk of infection prevents the routine measurement of central BP. Arterial transfer functions can provide central BP estimates from clinically available peripheral measurements. However, current methods are either generalized, potentially lacking the ability to adapt to inter and intra subject variability, or individualized based on additional, clinically unavailable, pulse transit time measurements. This work proposes a novel, self-contained method for individualizing an arterial transfer function from a single peripheral pressure measurement, capable of accurately estimating central BP in a range of hemodynamic conditions. METHODS Pulse wave analysis of femoral BP waves was employed to formulate initial approximations of central BP and arterial inlet flow waveforms, to serve as objective functions for the identification of all model parameters. Root mean squared error (RMSE), and systolic and pulse pressure errors were assessed with respect to invasive aortic BP measurements in a seven (7) porcine endotoxin experiments. Systolic and pulse pressure errors were analysed using Bland-Altman analysis. Method accuracy is also compared with an idealized transfer function, derived using the measured aortic-femoral pulse transit time and minimizing the RMSE of model output pressure with respect to reference aortic pressure, a generalized transfer function model, and invasive femoral pressure measurements. RESULTS Mean bias and limits of agreement (95% CI) for the proposed method were 1.0(-4.6, 6.7)mmHg and -1.0(-6.6, 4.6)mmHg for systolic and pulse pressure, respectively, compared to 3.6(-0.9, 8.2)mmHg and 2.7(-1.8, 7.3)mmHg for the generalized transfer function model. Mean bias and limits of agreement for femoral pressure measurements were -6.4(-15.0, 2.3)mmHg and -9.4(-18.1, -0.8)mmHg, for systolic and pulse pressure, respectively. The pooled mean and standard deviation of the RMSE produced by the single measurement method, relative to reference aortic pressure, was 4.3(1.1)mmHg, consistent with estimates produced by the idealized transfer function, 3.9(1.2)mmHg, and improving of the generalized transfer function, 4.6(1.4)mmHg. CONCLUSIONS The proposed single measurement method provides accurate central BP estimates from routinely available peripheral pressure measurements, and nothing else. The method allows for the individualization of transfer functions on a per patient basis to better capture changes in patient condition during the progression of disease and subsequent treatment, at no additional clinical cost.
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Affiliation(s)
- Liam Murphy
- Department of Mechanical Engineering, University of Canterbury, 20 Kirkwood Avenue, Christchurch, New Zealand.
| | - J Geoffrey Chase
- Department of Mechanical Engineering, University of Canterbury, 20 Kirkwood Avenue, Christchurch, New Zealand
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8
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Chaudhuri K, Pletzer A, Smith NP. A predictive patient-specific computational model of coronary artery bypass grafts for potential use by cardiac surgeons to guide selection of graft configurations. Front Cardiovasc Med 2022; 9:953109. [PMID: 36237904 PMCID: PMC9552835 DOI: 10.3389/fcvm.2022.953109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 09/01/2022] [Indexed: 01/09/2023] Open
Abstract
Cardiac surgeons face a significant degree of uncertainty when deciding upon coronary artery bypass graft configurations for patients with coronary artery disease. This leads to significant variation in preferred configuration between different surgeons for a particular patient. Additionally, for the majority of cases, there is no consensus regarding the optimal grafting strategy. This situation results in the tendency for individual surgeons to opt for a “one size fits all” approach and use the same grafting configuration for the majority of their patients neglecting the patient-specific nature of the diseased coronary circulation. Quantitative metrics to assess the adequacy of coronary bypass graft flows have recently been advocated for routine intraoperative use by cardiac surgeons. In this work, a novel patient-specific 1D-0D computational model called “COMCAB” is developed to provide the predictive haemodynamic parameters of functional graft performance that can aid surgeons to avoid configurations with grafts that have poor flow and thus poor patency. This model has significant potential for future expanded applications.
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Affiliation(s)
- Krish Chaudhuri
- Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand
- Green Lane Cardiothoracic Surgical Unit, Auckland City Hospital, Auckland, New Zealand
- *Correspondence: Krish Chaudhuri,
| | | | - Nicolas P. Smith
- Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand
- School of Mechanical, Medical and Process Engineering, Queensland University of Technology, Brisbane, QLD, Australia
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9
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Xiao H, Liu C, Zhang B. Reconstruction of central arterial pressure waveform based on CNN-BILSTM. Biomed Signal Process Control 2022. [DOI: 10.1016/j.bspc.2022.103513] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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10
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Liang Y, Mo P, Yang X, He Y, Zhang W, Zeng X, Xie L, Gao Q. Estimation of critical closing pressure using intravascular blood pressure of the common carotid artery. Med Eng Phys 2022; 102:103759. [DOI: 10.1016/j.medengphy.2022.103759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 01/01/2022] [Accepted: 01/14/2022] [Indexed: 10/19/2022]
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11
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Gil-Sala D, Guala A, Garcia Reyes ME, Azancot MA, Dux-Santoy L, Allegue Allegue N, Teixido Turà G, Goncalves Martins G, Ruiz Muñoz A, Constenla García I, Evangelista A, Tello Díaz C, Ferreira González I, Rodríguez-Palomares JF, Bellmunt S. Geometric, Biomechanic and Haemodynamic Aortic Abnormalities Assessed by 4D Flow Cardiovascular Magnetic Resonance in Patients Treated by TEVAR Following Blunt Traumatic Thoracic Aortic Injury. Eur J Vasc Endovasc Surg 2021; 62:797-807. [PMID: 34511317 DOI: 10.1016/j.ejvs.2021.07.016] [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: 11/25/2020] [Revised: 06/29/2021] [Accepted: 07/25/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Thoracic endovascular aortic repair (TEVAR) is widely used for the treatment of patients with blunt traumatic thoracic aortic injury (BTAI). However, aortic haemodynamic and biomechanical implications of this intervention are poorly investigated. This study aimed to assess whether patients treated by TEVAR following BTAI have thoracic aortic abnormalities in geometry, stiffness, and haemodynamics. METHODS Patients with BTAI treated by TEVAR at Vall d'Hebron Hospital between 1999 and 2019 were compared with propensity score matched healthy volunteers (HVs). All subjects underwent cardiovascular magnetic resonance (CMR) comprising a 4D flow CMR sequence. Spatially resolved aortic diameter, length, volume, and curvature were assessed. Pulse wave velocity, distensibility, and longitudinal strain (all measurements of aortic stiffness) were determined regionally. Moreover, advanced haemodynamic descriptors were quantified: systolic flow reversal ratio (SFRR), quantifying backward flow during systole, and in plane rotational flow (IRF), measuring in plane strength of helical flow. RESULTS Twenty-six BTAI patients treated by TEVAR were included and matched with 26 HVs. They did not differ in terms of age, sex, and body surface area. Patients with TEVAR had a larger and longer ascending aorta (AAo) and marked abnormalities in local curvature. Aortic stiffness was greater in the aortic segments proximal and distal to TEVAR compared with controls. Moreover, TEVAR patients presented strongly altered flow dynamics compared with controls: a reduced IRF from the distal AAo to the proximal descending aorta and an increased SFRR in the whole thoracic aorta. These differences persisted adjusting for cardiovascular risk factors and were independent of time elapsed since TEVAR implantation. CONCLUSION At long term follow up, previously healthy patients who underwent TEVAR implantation following BTAI had increased diameter, length and volume of the ascending aorta, and increased aortic stiffness and abnormal flow patterns in the whole thoracic aorta compared with matched controls. Further studies should address whether these alterations have clinical implications.
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Affiliation(s)
- Daniel Gil-Sala
- Vascular and Endovascular Surgery, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Departament de Cirurgia. Universitat Autònoma de Barcelona (UAB), Bellaterra, Spain
| | - Andrea Guala
- Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain; CIBER-CV, Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Marvin E Garcia Reyes
- Vascular and Endovascular Surgery, Hospital Universitari Vall d'Hebron, Barcelona, Spain.
| | - Maria A Azancot
- Department of Nephrology, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | | | | | - Gisela Teixido Turà
- Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain; CIBER-CV, Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Department of Cardiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Gabriela Goncalves Martins
- Vascular and Endovascular Surgery, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Departament de Cirurgia. Universitat Autònoma de Barcelona (UAB), Bellaterra, Spain
| | - Aroa Ruiz Muñoz
- Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain; CIBER-CV, Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Ivan Constenla García
- Vascular and Endovascular Surgery, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Arturo Evangelista
- Departament de Cirurgia. Universitat Autònoma de Barcelona (UAB), Bellaterra, Spain; Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain; CIBER-CV, Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Department of Cardiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Instituto del Corazón. Quirónsalud-Teknon. Barcelona, Spain
| | - Cristina Tello Díaz
- Vascular and Endovascular Surgery, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Ignacio Ferreira González
- Department of Cardiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain; CIBER-ESP, Instituto de Salud Carlos III, Madrid, Spain; Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Jose F Rodríguez-Palomares
- Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain; CIBER-CV, Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Department of Cardiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Sergi Bellmunt
- Vascular and Endovascular Surgery, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Departament de Cirurgia. Universitat Autònoma de Barcelona (UAB), Bellaterra, Spain
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12
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Sooriamoorthy D, Shanmugam SA, Juman M. A novel electrical impedance function to estimate central aortic blood pressure waveforms. Biomed Signal Process Control 2021. [DOI: 10.1016/j.bspc.2021.102649] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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13
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Abstract
OBJECTIVES Hypertension leads to aortic stiffening and dilatation but unexpected data from the Framingham Heart Study showed an inverse relationship between brachial pulse pressure and aortic diameter. Aortic dilatation would not only lead to lower pulse pressure but also to a worse prognosis (cardiac events, heart failure). Invasive pressure may be more informative but data are lacking. AIM This study evaluated the relationship between invasively measured central blood pressure and proximal aortic diameter. METHODS In 71 consecutive patients referred to invasive haemodynamic study, proximal aortic remodelling was evaluated in terms of Z-score, comparing diameters measured at the sinus of Valsalva to the diameter expected according to patients' age, sex and body height. Pressures were recorded directly in the proximal aorta by means of a catheter before coronary assessment. RESULTS The mean invasive aortic SBPs and DBPs were 146 ± 23 and 78 ± 13 mmHg, respectively, giving a central pulse pressure (cPP inv) of 68 ± 21 mmHg. Proximal aortic diameter was 34.9 ± 19.4 mm, whereas Z-score was -0.3 ± 1.7. Patients with higher cPPinv showed a significantly lower Z-score (-0.789 vs. 0.155, P = 0.001). cPPinv was inversely related to Z-score (R = -0.271, P = 0.022) independently from age, mean blood pressure and heart rate (β = -0.241, P = 0.011). CONCLUSION Aortic root Z-score is inversely associated with invasively measured central pulse pressure in a cohort of patients undergoing invasive coronary assessment. Remodelling at the sinuses of Valsalva may be a compensatory mechanism to limit pulse pressure.
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14
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Oscillometric estimates of aortic blood pressure as an alternative to carotid blood pressure to assess carotid stiffness in humans. Hypertens Res 2021; 44:888-890. [PMID: 33686264 DOI: 10.1038/s41440-021-00637-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 01/13/2021] [Accepted: 01/15/2021] [Indexed: 11/08/2022]
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15
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Mariscal-Harana J, Charlton PH, Vennin S, Aramburu J, Florkow MC, van Engelen A, Schneider T, de Bliek H, Ruijsink B, Valverde I, Beerbaum P, Grotenhuis H, Charakida M, Chowienczyk P, Sherwin SJ, Alastruey J. Estimating central blood pressure from aortic flow: development and assessment of algorithms. Am J Physiol Heart Circ Physiol 2020; 320:H494-H510. [PMID: 33064563 PMCID: PMC7612539 DOI: 10.1152/ajpheart.00241.2020] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Central blood pressure (cBP) is a highly prognostic cardiovascular (CV) risk factor whose accurate, invasive assessment is costly and carries risks to patients. We developed and assessed novel algorithms for estimating cBP from noninvasive aortic hemodynamic data and a peripheral blood pressure measurement. These algorithms were created using three blood flow models: the two- and three-element Windkessel (0-D) models and a one-dimensional (1-D) model of the thoracic aorta. We tested new and existing methods for estimating CV parameters (left ventricular ejection time, outflow BP, arterial resistance and compliance, pulse wave velocity, and characteristic impedance) required for the cBP algorithms, using virtual (simulated) subjects (n = 19,646) for which reference CV parameters were known exactly. We then tested the cBP algorithms using virtual subjects (n = 4,064), for which reference cBP were available free of measurement error, and clinical datasets containing invasive (n = 10) and noninvasive (n = 171) reference cBP waves across a wide range of CV conditions. The 1-D algorithm outperformed the 0-D algorithms when the aortic vascular geometry was available, achieving central systolic blood pressure (cSBP) errors≤2.1 ± 9.7mmHg and root-mean-square errors (RMSEs)≤6.4 ± 2.8mmHg against invasive reference cBP waves (n = 10). When the aortic geometry was unavailable, the three-element 0-D algorithm achieved cSBP errors ≤ 6.0 ± 4.7mmHg and RMSEs ≤ 5.9 ± 2.4mmHg against noninvasive reference cBP waves (n = 171), outperforming the two-element 0-D algorithm. All CV parameters were estimated with mean percentage errors ≤ 8.2%, except for the aortic characteristic impedance (≤13.4%), which affected the three-element 0-D algorithm’s performance. The freely available algorithms developed in this work enable fast and accurate calculation of the cBP wave and CV parameters in datasets containing noninvasive ultrasound or magnetic resonance imaging data.
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Affiliation(s)
- Jorge Mariscal-Harana
- Department of Biomedical Engineering, School of Biomedical Engineering and Imaging Sciences, King's College London, King's Health Partners, London, United Kingdom
| | - Peter H Charlton
- Department of Biomedical Engineering, School of Biomedical Engineering and Imaging Sciences, King's College London, King's Health Partners, London, United Kingdom
| | - Samuel Vennin
- Department of Biomedical Engineering, School of Biomedical Engineering and Imaging Sciences, King's College London, King's Health Partners, London, United Kingdom.,Department of Clinical Pharmacology, King's College London, King's Health Partners, London , United Kingdom
| | - Jorge Aramburu
- TECNUN Escuela de Ingenieros, Universidad de Navarra, Donostia-San Sebastián, Spain
| | - Mateusz Cezary Florkow
- Department of Biomedical Engineering, School of Biomedical Engineering and Imaging Sciences, King's College London, King's Health Partners, London, United Kingdom.,Philips Research, Cambridge, United Kingdom
| | - Arna van Engelen
- Department of Biomedical Engineering, School of Biomedical Engineering and Imaging Sciences, King's College London, King's Health Partners, London, United Kingdom
| | - Torben Schneider
- Philips Healthcare UK, Philips Centre, Guildford Business Park, Guildford, Surrey, United Kingdom
| | - Hubrecht de Bliek
- HSDP Clinical Platforms, Philips Healthcare, Eindhoven, The Netherlands
| | - Bram Ruijsink
- Department of Biomedical Engineering, School of Biomedical Engineering and Imaging Sciences, King's College London, King's Health Partners, London, United Kingdom.,Department of Cardiology, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Israel Valverde
- Department of Biomedical Engineering, School of Biomedical Engineering and Imaging Sciences, King's College London, King's Health Partners, London, United Kingdom.,Cardiovascular Pathophysiology, Institute of Biomedicine of Seville, University Hospital of Virgen del Rocío, University of Seville, CIBERCV, CSIC, Seville, Spain
| | - Philipp Beerbaum
- Department of Pediatric Cardiology and Intensive Care, Hannover Medical School, Hannover, Germany
| | - Heynric Grotenhuis
- Department of Pediatric Cardiology, University Medical Center Utrecht/Wilhelmina Children's Hospital, Utrecht, The Netherlands
| | - Marietta Charakida
- Department of Biomedical Engineering, School of Biomedical Engineering and Imaging Sciences, King's College London, King's Health Partners, London, United Kingdom
| | - Phil Chowienczyk
- Department of Clinical Pharmacology, King's College London, King's Health Partners, London , United Kingdom
| | - Spencer J Sherwin
- Department of Aeronautics, South Kensington Campus, Imperial College London, London, United Kingdom
| | - Jordi Alastruey
- Department of Biomedical Engineering, School of Biomedical Engineering and Imaging Sciences, King's College London, King's Health Partners, London, United Kingdom.,Institute of Personalized Medicine, Sechenov University, Moscow, Russia
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16
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Gallo C, Ridolfi L, Scarsoglio S. Cardiovascular deconditioning during long-term spaceflight through multiscale modeling. NPJ Microgravity 2020; 6:27. [PMID: 33083524 PMCID: PMC7529778 DOI: 10.1038/s41526-020-00117-5] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Accepted: 08/10/2020] [Indexed: 12/20/2022] Open
Abstract
Human spaceflight has been fascinating man for centuries, representing the intangible need to explore the unknown, challenge new frontiers, advance technology, and push scientific boundaries further. A key area of importance is cardiovascular deconditioning, that is, the collection of hemodynamic changes-from blood volume shift and reduction to altered cardiac function-induced by sustained presence in microgravity. A thorough grasp of the 0G adjustment point per se is important from a physiological viewpoint and fundamental for astronauts' safety and physical capability on long spaceflights. However, hemodynamic details of cardiovascular deconditioning are incomplete, inconsistent, and poorly measured to date; thus a computational approach can be quite valuable. We present a validated 1D-0D multiscale model to study the cardiovascular response to long-term 0G spaceflight in comparison to the 1G supine reference condition. Cardiac work, oxygen consumption, and contractility indexes, as well as central mean and pulse pressures were reduced, augmenting the cardiac deconditioning scenario. Exercise tolerance of a spaceflight traveler was found to be comparable to an untrained person with a sedentary lifestyle. At the capillary-venous level significant waveform alterations were observed which can modify the regular perfusion and average nutrient supply at the cellular level. The present study suggests special attention should be paid to future long spaceflights which demand prompt physical capacity at the time of restoration of partial gravity (e.g., Moon/Mars landing). Since spaceflight deconditioning has features similar to accelerated aging understanding deconditioning mechanisms in microgravity are also relevant to the understanding of aging physiology on the Earth.
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Affiliation(s)
- Caterina Gallo
- Department of Mechanical and Aerospace Engineering, Politecnico di Torino, Torino, Italy
| | - Luca Ridolfi
- Department of Environmental, Land and Infrastructure Engineering, Politecnico di Torino, Torino, Italy
| | - Stefania Scarsoglio
- Department of Mechanical and Aerospace Engineering, Politecnico di Torino, Torino, Italy
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17
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Bikia V, Pagoulatou S, Trachet B, Soulis D, Protogerou AD, Papaioannou TG, Stergiopulos N. Noninvasive Cardiac Output and Central Systolic Pressure From Cuff-Pressure and Pulse Wave Velocity. IEEE J Biomed Health Inform 2019; 24:1968-1981. [PMID: 31796418 DOI: 10.1109/jbhi.2019.2956604] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
GOAL We introduce a novel approach to estimate cardiac output (CO) and central systolic blood pressure (cSBP) from noninvasive measurements of peripheral cuff-pressure and carotid-to-femoral pulse wave velocity (cf-PWV). METHODS The adjustment of a previously validated one-dimensional arterial tree model is achieved via an optimization process. In the optimization loop, compliance and resistance of the generic arterial tree model as well as aortic flow are adjusted so that simulated brachial systolic and diastolic pressures and cf-PWV converge towards the measured brachial systolic and diastolic pressures and cf-PWV. The process is repeated until full convergence in terms of both brachial pressures and cf-PWV is reached. To assess the accuracy of the proposed framework, we implemented the algorithm on in vivo anonymized data from 20 subjects and compared the method-derived estimates of CO and cSBP to patient-specific measurements obtained with Mobil-O-Graph apparatus (central pressure) and two-dimensional transthoracic echocardiography (aortic blood flow). RESULTS Both CO and cSBP estimates were found to be in good agreement with the reference values achieving an RMSE of 0.36 L/min and 2.46 mmHg, respectively. Low biases were reported, namely -0.04 ± 0.36 L/min for CO predictions and -0.27 ± 2.51 mmHg for cSBP predictions. SIGNIFICANCE Our one-dimensional model can be successfully "tuned" to partially patient-specific standards by using noninvasive, easily obtained peripheral measurement data. The in vivo evaluation demonstrated that this method can potentially be used to obtain central aortic hemodynamic parameters in a noninvasive and accurate way.
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18
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Scolletta S, Herpain A, Romano SM, Taccone FS, Donadello K, Lubicz B, Franchi F, Kaefer KM, Polati E, Vincent JL, De Backer D. Estimation of central arterial pressure from the radial artery in patients undergoing invasive neuroradiological procedures. BMC Anesthesiol 2019; 19:173. [PMID: 31484508 PMCID: PMC6727486 DOI: 10.1186/s12871-019-0844-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2019] [Accepted: 08/26/2019] [Indexed: 01/29/2023] Open
Abstract
Backgrounds Central arterial pressure can be derived from analysis of the peripheral artery waveform. The aim of this study was to compare central arterial pressures measured from an intra-aortic catheter with peripheral radial arterial pressures and with central arterial pressures estimated from the peripheral pressure wave using a pressure recording analytical method (PRAM). Methods We studied 21 patients undergoing digital subtraction cerebral angiography under local or general anesthesia and equipped with a radial arterial catheter. A second catheter was placed in the ascending aorta for central pressure wave acquisition. Central (AO) and peripheral (RA) arterial waveforms were recorded simultaneously by PRAM for 90–180 s. During an off-line analysis, AO pressures were reconstructed (AOrec) from the RA trace using a mathematical model obtained by multi-linear regression analysis. The AOrec values obtained by PRAM were compared with the true central pressure value obtained from the catheter placed in the ascending aorta. Results Systolic, diastolic and mean pressures ranged from 79 to 180 mmHg, 47 to 102 mmHg, and 58 to 128 mmHg, respectively, for AO, and 83 to 174 mmHg, 47 to 107 mmHg, and 60 to 129 mmHg, respectively, for RA. The correlation coefficients between AO and RA were 0.86 (p < 0.01), 0.83 (p < 0.01) and 0.86 (p < 0.01) for systolic, diastolic and mean pressures, respectively, and the mean differences − 0.3 mmHg, 2.4 mmHg and 1.5 mmHg. The correlation coefficients between AO and AOrec were 0.92 (p < 0.001), 0.87 (p < 0.001) and 0.92 (p < 0.001), for systolic, diastolic and mean pressures, respectively, and the mean differences 0.01 mmHg, 1.8 mmHg and 1.2 mmHg. Conclusions PRAM can provide reliable estimates of central arterial pressure. Electronic supplementary material The online version of this article (10.1186/s12871-019-0844-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Sabino Scolletta
- Department of Intensive Care, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium. .,Department of Medicine, Surgery and Neurosciences, Anesthesia and Intensive Care Unit, University Hospital of Siena, Siena, Italy.
| | - Antoine Herpain
- Department of Intensive Care, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - Salvatore Mario Romano
- Department of Heart and Vessels, University of Florence, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Fabio Silvio Taccone
- Department of Intensive Care, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - Katia Donadello
- Department of Intensive Care, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium.,Anesthesia and Intensive Care B, Department of Surgery, Dentistry, Paediatrics and Gynaecology, University of Verona, AOUI, University Hospital Integrated Trust of Verona, Verona, Italy
| | - Boris Lubicz
- Department of Interventional Neuroradiology, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - Federico Franchi
- Department of Medicine, Surgery and Neurosciences, Anesthesia and Intensive Care Unit, University Hospital of Siena, Siena, Italy
| | - Keitiane Michele Kaefer
- Department of Intensive Care, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - Enrico Polati
- Anesthesia and Intensive Care B, Department of Surgery, Dentistry, Paediatrics and Gynaecology, University of Verona, AOUI, University Hospital Integrated Trust of Verona, Verona, Italy
| | - Jean-Louis Vincent
- Department of Intensive Care, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - Daniel De Backer
- Department of Intensive Care, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium.,Department of Intensive Care, CHIREC Hospitals, Université Libre de Bruxelles, Brussels, Belgium
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