Burattini R, Natalucci S
Department of Electronics and Automatica, University of Ancona, Italy.
Med Eng Phys. 1998 Oct;20(7):502-14. doi: 10.1016/s1350-4533(98)00055-1.
Based on simulated data, recent studies by others showed that fitting measured pulse pressure with the pulse pressure predicted by the two-element windkessel (W2-based pulse pressure method, PPM) yielded estimates of total arterial compliance closer to simulated values than other estimation methods that use either the W2 model or the three-element windkessel (W3). A later experimental application of the PPM, made by us, however, yielded relatively non pressure dependent estimates of compliance that were in contradiction with pressure dependent estimates obtained from the W2 model by fitting to the full aortic pressure wave (full pressure method, FPM). To explain these contradictory findings, in the present study we interpreted the aortic input impedance in terms of a viscoelastic windkessel (VW), where total peripheral resistance is connected in parallel to a complex and frequency dependent compliance, Cc(j omega), described by the Voigt cell. Using ascending aortic pressure and flow taken from four dogs, under a variety of haemodynamic states, we compared the estimates of compliance obtained from the W3 and VW models and from different W2-based estimation methods: the FPM (Cw2), the PPM (Cpp), the decay time method, DTM (Cdt), and the area method, AM (C(am)). The VW-based estimates of complex compliance resolved contradictions in the W2-based estimates. Static compliance of VW-model, Cvw = Cc(0), showed a good correlation (p = 0.999) with Cw2. Correlation of static compliance with C(am) and Cdt estimates was affected by distortions in diastolic pressure decay. The modulus of VW model's dynamic compliance, ¿Cc(omega(h))¿, at the heart pulsation omega(h), was well correlated (p = 0.975) with Cpp. Analysis of data fit and compliance estimates indicated that the VW model yields an improvement over the W3 in the physical interpretation of the overall arterial properties.
基于模拟数据,其他人最近的研究表明,将测量的脉压与双元件风箱模型(基于W2的脉压法,PPM)预测的脉压进行拟合,与使用W2模型或三元件风箱模型(W3)的其他估计方法相比,所得到的总动脉顺应性估计值更接近模拟值。然而,我们随后对PPM的实验应用得出的顺应性估计值相对与压力无关,这与通过拟合整个主动脉压力波(全压力法,FPM)从W2模型获得的与压力有关的估计值相矛盾。为了解释这些相互矛盾的发现,在本研究中,我们用粘弹性风箱(VW)来解释主动脉输入阻抗,其中总外周阻力与一个由Voigt单元描述的复杂且频率依赖的顺应性Cc(jω)并联。我们利用从四只狗身上获取的升主动脉压力和流量,在各种血流动力学状态下,比较了从W3和VW模型以及不同的基于W2的估计方法获得的顺应性估计值:FPM(Cw2)、PPM(Cpp)、衰减时间法(DTM,Cdt)和面积法(AM,C(am))。基于VW的复顺应性估计值解决了基于W2的估计值中的矛盾。VW模型的静态顺应性Cvw = Cc(0)与Cw2显示出良好的相关性(p = 0.999)。静态顺应性与C(am)和Cdt估计值的相关性受到舒张压衰减失真的影响。VW模型在心脏搏动频率ωh下的动态顺应性模量|Cc(ωh)|与Cpp具有良好的相关性(p = 0.975)。对数据拟合和顺应性估计的分析表明,VW模型在整体动脉特性的物理解释方面比W3有所改进。