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On the Estimation of Total Arterial Compliance from Aortic Pulse Wave Velocity

Nikolaos Stergiopoulos, Orestis Vardoulis
2012
Journal paper
Abstract

Total arterial compliance (C (T)) is a main determinant of cardiac afterload, left ventricular function and arterio-ventricular coupling. C (T) is physiologically more relevant than regional aortic stiffness. However, direct, in vivo, non-invasive, measurement of C (T) is not feasible. Several methods for indirect C (T) estimation require simultaneous recording of aortic flow and pressure waves, limiting C (T) assessment in clinical practice. In contrast, aortic pulse wave velocity (aPWV) measurement, which is considered as the "gold standard" method to assess arterial stiffness, is noninvasive and relatively easy. Our aim was to establish the relation between aPWV and C (T). In total, 1000 different hemodynamic cases were simulated, by altering heart rate, compliance, resistance and geometry using an accurate, distributed, nonlinear, one-dimensional model of the arterial tree. Based on Bramwell-Hill theory, the formula was found to accurately estimate C (T) from aPWV. Coefficient k was determined both analytically and by fitting C (T) vs. aPWV data. C (T) estimation may provide an additional tool for cardiovascular risk (CV) assessment and better management of CV diseases. C (T) could have greater impact in assessing elderly population or subjects with elevated arterial stiffness, where aPWV seem to have limited prognostic value. Further clinical studies should be performed to validate the formula in vivo.

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Ontological neighbourhood
Health sciences
Related concepts (32)
Blood pressure
Blood pressure (BP) is the pressure of circulating blood against the walls of blood vessels. Most of this pressure results from the heart pumping blood through the circulatory system. When used without qualification, the term "blood pressure" refers to the pressure in a brachial artery, where it is most commonly measured. Blood pressure is usually expressed in terms of the systolic pressure (maximum pressure during one heartbeat) over diastolic pressure (minimum pressure between two heartbeats) in the cardiac cycle.
Cardiac output
In cardiac physiology, cardiac output (CO), also known as heart output and often denoted by the symbols , , or , is the volumetric flow rate of the heart's pumping output: that is, the volume of blood being pumped by a single ventricle of the heart, per unit time (usually measured per minute). Cardiac output (CO) is the product of the heart rate (HR), i.e. the number of heartbeats per minute (bpm), and the stroke volume (SV), which is the volume of blood pumped from the left ventricle per beat; thus giving the formula: Values for cardiac output are usually denoted as L/min.
Aortic stenosis
Aortic stenosis (AS or AoS) is the narrowing of the exit of the left ventricle of the heart (where the aorta begins), such that problems result. It may occur at the aortic valve as well as above and below this level. It typically gets worse over time. Symptoms often come on gradually with a decreased ability to exercise often occurring first. If heart failure, loss of consciousness, or heart related chest pain occur due to AS the outcomes are worse. Loss of consciousness typically occurs with standing or exercising.
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