Key result
Accounting for peripheral reflections in wave intensity analysis reduced errors in estimating pulse wave velocity from 9.5% to 1.3% and transit time from 27% to 10%.
A novel wave intensity analysis that accounts for peripheral reflections significantly improves the accuracy of pulse wave velocity and transit time estimations in arterial models.
Enhances PWV estimation accuracy in animal models; leaves open translation to human clinical assessment.
We present a novel analysis of arterial pulse wave propagation that combines traditional wave intensity analysis with identification of Windkessel pressures to account for the effect on the pressure waveform of peripheral wave reflections. Using haemodynamic data measured in vivo in the rabbit or generated numerically in models of human compliant vessels, we show that traditional wave intensity analysis identifies the timing, direction and magnitude of the predominant waves that shape aortic pressure and flow waveforms in systole, but fails to identify the effect of peripheral reflections. These reflections persist for several cardiac cycles and make up most of the pressure waveform, especially in diastole and early systole. Ignoring peripheral reflections leads to an erroneous indication of a reflection-free period in early systole and additional error in the estimates of (i) pulse wave velocity at the ascending aorta given by the PU-loop method (9.5% error) and (ii) transit time to a dominant reflection site calculated from the wave intensity profile (27% error). These errors decreased to 1.3% and 10%, respectively, when accounting for peripheral reflections. Using our new analysis, we investigate the effect of vessel compliance and peripheral resistance on wave intensity, peripheral reflections and reflections originating in previous cardiac cycles.
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Alastruey et al. (2013) studied Arterial pulse wave propagation. Novel wave intensity analysis accounting for peripheral reflections vs. Traditional wave intensity analysis was evaluated on Error in estimates of pulse wave velocity and transit time. Accounting for peripheral reflections in wave intensity analysis reduced errors in estimating pulse wave velocity from 9.5% to 1.3% and transit time from 27% to 10%.
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