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仅根据压力波形估计波条件数及其在健康女性和男性中随年龄增长的变化。

Estimation of Wave Condition Number From Pressure Waveform Alone and Its Changes With Advancing Age in Healthy Women and Men.

作者信息

Pahlevan Niema M, Mazandarani Sohrab P

机构信息

Department of Aerospace Mechanical Engineering, University of Southern California, Los Angeles, CA, United States.

Division of Cardiovascular Medicine, Department of Medicine, University of Southern California, Los Angeles, CA, United States.

出版信息

Front Physiol. 2020 Apr 9;11:313. doi: 10.3389/fphys.2020.00313. eCollection 2020.

Abstract

INTRODUCTION

The wave condition number (WCN) is a non-dimensional number that determines the state of arterial wave reflections. WCN is equal to HR × L /PWV where HR, L , and PWV are the heart rate, effective length, and pulse wave velocity, respectively. It has been shown that a value of WCN = 0.1 indicates the optimum state of arterial wave reflection in which left ventricle workload is minimized. The pressure wave, flow wave, and PWV are all required to compute WCN, which may limit the potential clinical utility of WCN. The aims of this study are as follows: (1) to assess the feasibility of approximating WCN from the pressure waveform alone (WCN ), and (2) to provide the proof-of-concept that WCN can capture age related differences in arterial wave reflection among healthy women and men.

METHODS

Previously published retrospective data composed of seventeen patients (age 19-54 years; 34.3 ± 9.6) were used to assess the accuracy of WCN . The exact value of WCN was computed from PWV (measured by foot-to-foot method), HR, and L . A quarter wavelength relationship with minimum impedance modulus were used to compute L . WCN was calculated using HR and the reflected wave arrival time. Previously published analyses from a healthy subset of the Anglo-Cardiff Collaborative Trial (ACCT) study population were used to investigate if non-invasive WCN captures age related differences in arterial wave reflection among healthy women and men.

RESULTS

A strong correlation ( = 0.83, -value <0.0001) between WCN and WCN was observed. The accuracy of WCN was independent from relevant physiological parameters such as PWV, pulse pressure (PP), and HR. Similar changes in WCN with advancing age were observed in both healthy men and healthy women. In young, healthy individuals (women and men) the WCN was around 0.1 (the optimum value), and reduced with aging.

CONCLUSION

WCN can be approximated from a single pressure waveform and can capture age related arterial wave reflection alteration. These results are clinically significant since WCN can be extracted from a single non-invasive pressure waveform. Future studies will focus on investigating if WCN is associated with risk for onset of cardiovascular disease events.

摘要

引言

波条件数(WCN)是一个无量纲数,用于确定动脉波反射的状态。WCN等于心率(HR)×有效长度(L)/脉搏波速度(PWV),其中HR、L和PWV分别代表心率、有效长度和脉搏波速度。研究表明,WCN值为0.1时表示动脉波反射的最佳状态,此时左心室负荷最小。计算WCN需要压力波、血流波和PWV,这可能限制了WCN在临床上的潜在应用。本研究的目的如下:(1)评估仅从压力波形估算WCN(WCN')的可行性;(2)提供概念验证,即WCN'能够捕捉健康男性和女性中与年龄相关的动脉波反射差异。

方法

使用先前发表的由17名患者(年龄19 - 54岁;34.3±9.6)组成的回顾性数据来评估WCN'的准确性。WCN的精确值通过PWV(采用足 - 足法测量)、HR和L计算得出。利用与最小阻抗模量的四分之一波长关系来计算L。WCN'使用HR和反射波到达时间进行计算。使用先前发表的英 - 加的夫协作试验(ACCT)研究人群中健康子集的分析数据,来研究无创WCN'是否能捕捉健康男性和女性中与年龄相关的动脉波反射差异。

结果

观察到WCN'与WCN之间存在强相关性(r = 0.83,p值<0.0001)。WCN'的准确性独立于诸如PWV、脉压(PP)和HR等相关生理参数。在健康男性和健康女性中均观察到WCN'随年龄增长有类似变化。在年轻健康个体(女性和男性)中,WCN'约为0.1(最佳值),并随年龄增长而降低。

结论

WCN可从单个压力波形估算得出,并且能够捕捉与年龄相关的动脉波反射变化。这些结果具有临床意义,因为WCN可从单个无创压力波形中提取。未来的研究将集中于调查WCN是否与心血管疾病事件发作风险相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/58fb/7161432/4cec3489a30b/fphys-11-00313-g001.jpg

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