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Estimating Central Pulse Pressure From Blood Flow by Identifying the Main Physical Determinants of Pulse Pressure Amplification

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...

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Autores principales: Flores Gerónimo, Joaquín, Corvera Poiré, Eugenia, Chowienczyk, Philip, Alastruey, Jordi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7940670/
https://www.ncbi.nlm.nih.gov/pubmed/33708133
http://dx.doi.org/10.3389/fphys.2021.608098
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author Flores Gerónimo, Joaquín
Corvera Poiré, Eugenia
Chowienczyk, Philip
Alastruey, Jordi
author_facet Flores Gerónimo, Joaquín
Corvera Poiré, Eugenia
Chowienczyk, Philip
Alastruey, Jordi
author_sort Flores Gerónimo, Joaquín
collection PubMed
description 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 (ΔPP). 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 ΔPP 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 ΔPP 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.
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spelling pubmed-79406702021-03-10 Estimating Central Pulse Pressure From Blood Flow by Identifying the Main Physical Determinants of Pulse Pressure Amplification Flores Gerónimo, Joaquín Corvera Poiré, Eugenia Chowienczyk, Philip Alastruey, Jordi Front Physiol Physiology 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 (ΔPP). 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 ΔPP 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 ΔPP 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. Frontiers Media S.A. 2021-02-23 /pmc/articles/PMC7940670/ /pubmed/33708133 http://dx.doi.org/10.3389/fphys.2021.608098 Text en Copyright © 2021 Flores Gerónimo, Corvera Poiré, Chowienczyk and Alastruey. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Physiology
Flores Gerónimo, Joaquín
Corvera Poiré, Eugenia
Chowienczyk, Philip
Alastruey, Jordi
Estimating Central Pulse Pressure From Blood Flow by Identifying the Main Physical Determinants of Pulse Pressure Amplification
title Estimating Central Pulse Pressure From Blood Flow by Identifying the Main Physical Determinants of Pulse Pressure Amplification
title_full Estimating Central Pulse Pressure From Blood Flow by Identifying the Main Physical Determinants of Pulse Pressure Amplification
title_fullStr Estimating Central Pulse Pressure From Blood Flow by Identifying the Main Physical Determinants of Pulse Pressure Amplification
title_full_unstemmed Estimating Central Pulse Pressure From Blood Flow by Identifying the Main Physical Determinants of Pulse Pressure Amplification
title_short Estimating Central Pulse Pressure From Blood Flow by Identifying the Main Physical Determinants of Pulse Pressure Amplification
title_sort estimating central pulse pressure from blood flow by identifying the main physical determinants of pulse pressure amplification
topic Physiology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7940670/
https://www.ncbi.nlm.nih.gov/pubmed/33708133
http://dx.doi.org/10.3389/fphys.2021.608098
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