title: A database of virtual healthy subjects to assess the accuracy of foot-to-foot pulse wave velocities for estimation of aortic stiffness.
abstract: 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, and carotid-radial) are being studied as substitutes of this central measurement. We present a novel methodology to assess theoretically these computed indexes and the hemodynamics mechanisms relating them. We created a database of 3,325 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 was computed from numerical pressure waveforms at the same locations where clinical measurements are commonly taken. Our numerical results confirm clinical observations: 1) carotid-femoral PWV is a good indicator of aortic stiffness and correlates well with aortic PWV; 2) brachial-ankle PWV overestimates aortic PWV and is related to the stiffness and geometry of both elastic and muscular arteries; and 3) muscular PWV (carotid-radial, femoral-ankle) does 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 indexes based on pulse wave analysis.
authors.affiliation: Division of Imaging Sciences and Biomedical Engineering, St. Thomas' Hospital, King's College London, London, United Kingdom; and marie.willemet@gmail.com.
authors.forename: Marie
authors.initials: M
authors.lastname: Willemet
authors.affiliation: Department of Clinical Pharmacology, St Thomas' Hospital, King's College London, London, United Kingdom.
authors.forename: Phil
authors.initials: P
authors.lastname: Chowienczyk
authors.affiliation: Division of Imaging Sciences and Biomedical Engineering, St. Thomas' Hospital, King's College London, London, United Kingdom; and.
authors.forename: Jordi
authors.initials: J
authors.lastname: Alastruey
mesh_terms: D000328:Adult; D000368:Aged; D001011:Aorta / Q000502:physiology*; D066264:Datasets as Topic; D005260:Female; D064368:Healthy Volunteers; D006801:Humans; D008297:Male; D008875:Middle Aged; D063177:Pulse Wave Analysis / Q000379:methods* / Q000592:standards; D059629:Signal-To-Noise Ratio; D059289:Vascular Stiffness
keywords: aortic stiffness; brachial-ankle PWV; carotid-femoral PWV; database of virtual subjects; numerical 1D model