title: Central Pressure Appraisal: Clinical Validation of a Subject-Specific Mathematical Model.
abstract: BACKGROUND
  Current evidence suggests that aortic blood pressure has a superior prognostic value with respect to brachial pressure for cardiovascular events, but direct measurement is not feasible in daily clinical practice.
  
  
  OBJECTIVE
  The aim of the present study is the clinical validation of a multiscale mathematical model for non-invasive appraisal of central blood pressure from subject-specific characteristics.
  
  
  METHODS
  A total of 51 young male were selected for the present study. Aortic systolic and diastolic pressure were estimated with a mathematical model and were compared to the most-used non-invasive validated technique (SphygmoCor device, AtCor Medical, Australia). SphygmoCor was calibrated through diastolic and systolic brachial pressure obtained with a sphygmomanometer, while model inputs consist of brachial pressure, height, weight, age, left-ventricular end-systolic and end-diastolic volumes, and data from a pulse wave velocity study.
  
  
  RESULTS
  Model-estimated systolic and diastolic central blood pressures resulted to be significantly related to SphygmoCor-assessed central systolic (r = 0.65 p <0.0001) and diastolic (r = 0.84 p<0.0001) blood pressures. The model showed a significant overestimation of systolic pressure (+7.8 (-2.2;14) mmHg, p = 0.0003) and a significant underestimation of diastolic values (-3.2 (-7.5;1.6), p = 0.004), which imply a significant overestimation of central pulse pressure. Interestingly, model prediction errors mirror the mean errors reported in large meta-analysis characterizing the use of the SphygmoCor when non-invasive calibration is performed.
  
  
  CONCLUSIONS
  In conclusion, multi-scale mathematical model predictions result to be significantly related to SphygmoCor ones. Model-predicted systolic and diastolic aortic pressure resulted in difference of less than 10 mmHg in the 51% and 84% of the subjects, respectively, when compared with SphygmoCor-obtained pressures.
authors.affiliation: Department of Medical Sciences, Division of Internal Medicine, Hypertension Unit, University Hospital 'AOU Città della Salute e della Scienza di Torino', University of Torino, Torino, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Tosello
authors.affiliation: DIATI, Politecnico di Torino, Turin, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Guala
authors.affiliation: Department of Medical Sciences, Division of Internal Medicine, Hypertension Unit, University Hospital 'AOU Città della Salute e della Scienza di Torino', University of Torino, Torino, Italy.
authors.forename: Dario
authors.initials: D
authors.lastname: Leone
authors.affiliation: DIATI, Politecnico di Torino, Turin, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Camporeale
authors.affiliation: Department of Medical Sciences, Division of Internal Medicine, Hypertension Unit, University Hospital 'AOU Città della Salute e della Scienza di Torino', University of Torino, Torino, Italy.
authors.forename: Giulia
authors.initials: G
authors.lastname: Bruno
authors.affiliation: DIATI, Politecnico di Torino, Turin, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Ridolfi
authors.affiliation: Department of Medical Sciences, Division of Internal Medicine, Hypertension Unit, University Hospital 'AOU Città della Salute e della Scienza di Torino', University of Torino, Torino, Italy.
authors.forename: Franco
authors.initials: F
authors.lastname: Veglio
authors.affiliation: Department of Medical Sciences, Division of Internal Medicine, Hypertension Unit, University Hospital 'AOU Città della Salute e della Scienza di Torino', University of Torino, Torino, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Milan
mesh_terms: D000328:Adult; D001011:Aorta / Q000502:physiology; D062186:Arterial Pressure; D001795:Blood Pressure Determination; D001916:Brachial Artery / Q000502:physiology; D003971:Diastole; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008955:Models, Cardiovascular; D066230:Patient-Specific Modeling; D013599:Systole; D055815:Young Adult