Bogatu Laura I, Turco Simona, Mischi Massimo, Woerlee Pierre, Bouwman Arthur, Korsten Erik H H M, Muehlsteff Jens
Patient Care and Measurements, Philips Research, Eindhoven, 5656 AE, Netherlands; Biomedical Diagnostics, Eindhoven University of Technology, Eindhoven, 5612 AZ, Netherlands.
Biomedical Diagnostics, Eindhoven University of Technology, Eindhoven, 5612 AZ, Netherlands.
Comput Methods Programs Biomed. 2020 Nov;196:105492. doi: 10.1016/j.cmpb.2020.105492. Epub 2020 Jun 12.
Measurement of arterial compliance is recognized as important for clinical use and for enabling better understanding of circulatory system regulation mechanisms. Estimation of arterial compliance involves either a direct measure of the ratio between arterial volume and pressure changes or an inference from the pulse wave velocity (PWV). In this study we demonstrate an approach to assess arterial compliance by fusion of these two information sources. The approach is based on combining oscillometry as used for blood pressure inference and PWV measurements based on ECG/PPG. Enabling reliable arterial compliance measurements will contribute to the understanding of regulation mechanisms of the arterial tree, possibly establishing arterial compliance as a key measure relevant in hemodynamic monitoring.
A measurement strategy, a physiological model, and a framework based on Bayesian principles are developed for measuring changes in arterial compliance based on combining oscillometry and PWV data. A simulation framework is used to study and validate the algorithm and measurement principle in detail, motivated by previous experimental findings.
Simulations demonstrate the possibility of inferring arterial compliance via fusion of simultaneously acquired volume/pressure relationships and PWV data. In addition, the simulation framework demonstrates how Bayesian principles can be used to handle low signal - to - noise ratio and partial information loss.
The developed simulation framework shows the feasibility of the proposed approach for assessment of arterial compliance by combining multiple data sources. This represents a first step towards integration of arterial compliance measurements in hemodynamic monitoring using existing clinical technology. The Bayesian approach is of particular relevance for such patient monitoring settings, where measurements are repeated frequently, context is relevant, and data is affected by artefacts. In addition, the simulation framework is necessary for future clinical-study design, in order to determine device specifications and the extent to which noise affects the inference process.
动脉顺应性的测量对于临床应用以及更好地理解循环系统调节机制具有重要意义。动脉顺应性的评估方法包括直接测量动脉容积与压力变化的比值,或从脉搏波速度(PWV)进行推断。在本研究中,我们展示了一种通过融合这两种信息源来评估动脉顺应性的方法。该方法基于将用于血压推断的示波法与基于心电图/光电容积脉搏波描记法(PPG)的PWV测量相结合。实现可靠的动脉顺应性测量将有助于理解动脉树的调节机制,有可能将动脉顺应性确立为血流动力学监测中的一项关键指标。
基于示波法和PWV数据的结合,开发了一种测量策略、生理模型以及基于贝叶斯原理的框架,用于测量动脉顺应性的变化。受先前实验结果的启发,使用模拟框架对算法和测量原理进行了详细研究和验证。
模拟结果表明,通过融合同时获取的容积/压力关系和PWV数据来推断动脉顺应性是可行的。此外,模拟框架展示了如何利用贝叶斯原理来处理低信噪比和部分信息丢失的情况。
所开发的模拟框架表明了通过结合多个数据源来评估动脉顺应性的提议方法的可行性。这代表了朝着使用现有临床技术将动脉顺应性测量整合到血流动力学监测中的第一步。贝叶斯方法对于此类患者监测设置尤为重要,在这些设置中,测量频繁重复,背景相关,且数据受伪影影响。此外,模拟框架对于未来的临床研究设计是必要的,以便确定设备规格以及噪声对推断过程的影响程度。