Publication

On the assessment of arterial compliance from carotid pressure waveform

Résumé

In a progressively aging population, it is of utmost importance to develop reliable, noninvasive, and cost-effective tools to estimate biomarkers that can be indicative of cardiovascular risk. Various pathophysiological conditions are associated to changes in the total arterial compliance (C-T), and thus, its estimation via an accurate and simple method is valuable. Direct noninvasive measurement of C-T is not feasible in the clinical practice. Previous methods exist for indirect estimation of C-T, which, however, require noninvasive, yet complex and expensive, recordings of the central pressure and flow. Here, we introduce a novel, noninvasive method for estimating C-T from a single carotid waveform measurement using regression analysis. Features were extracted from the carotid wave and were combined with demographic data. A prediction pipeline was adopted for estimating C-T using, first, a feature-based regression analysis and, second, the raw carotid pulse wave. The proposed methodology was appraised using the large human cohort (N = 2,256) of the Asklepios study. Accurate estimates of C-T were yielded for both prediction schemes, namely, r = 0.83 and normalized root mean square error (nRMSE) = 9.58% for the feature-based model, and r = 0.83 and nRSME = 9.67% for the model that used the raw signal. The major advantage of this method pertains to the simplification of the technique offering easily applicable and convenient C-T monitoring. Such an approach could offer promising applications, ranging from fast and cost-efficient hemodynamical monitoring by the physician to integration in wearable technologies. NEW & NOTEWORTHY This article introduces a novel artificial intelligence method to estimate total arterial compliance (C-T) via exploiting the information provided by an uncalibrated carotid blood pressure waveform as well as typical clinical variables. The major finding of this study is that C-T, which is usually acquired using both pressure and flow waveforms, can be accurately derived by the use of the pressure wave alone. This method could potentially facilitate easily applicable and convenient monitoring of C-T.

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Concepts associés (34)
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.
Débit cardiaque
Le est le volume de sang fourni par le cœur par unité de temps. Il s’exprime en L/min Comme pour toute mesure de débit, il s'agit de mesurer le volume fourni par l'appareil étudié (ici le cœur) par unité de temps. Si l'on peut mesurer le débit d'un robinet d'eau en recueillant la totalité du liquide émis par celui-ci, on ne peut pas recueillir la totalité du volume de sang fourni par le cœur, faute de survie du sujet étudié. Dans ces cas là, on utilise la méthode de dilution d'un index.
Effet Windkessel
L'effet Windkessel (littéralement "chambre à air") est le nom donné au phénomène physiologique permettant au niveau du réseau artériel de transformer le débit discontinu pulsé du sang en débit continu. Il a été décrit en 1899 par le . Cette régulation du débit cardiaque est due à la dilatation de la paroi de l'aorte et des gros vaisseaux pendant la phase d'éjection systolique. Ce qui signifie que le débit discontinu va être lissé en flux continu même pendant la phase de diastole.
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