Key result
In a computational model, wave separation and wave intensity analysis yielded comparable results, and a newly defined Descending Index increased from 0.53 in the normal aorta to 0.96 with 80% coarctation.
Why the study?
Does a descending index derived from arterial wave analysis correlate with the severity of aortic coarctation in a computational model?
Does a descending index derived from arterial wave analysis correlate with the severity of aortic coarctation in a computational model?
A novel descending index derived from arterial wave analysis in a computational model correlates with aortic coarctation severity and may aid in early noninvasive diagnosis.
Answers are grounded in this paper and cite their sources.
Descending Index tracks coarctation severity in silico; leaves open translation to noninvasive human diagnosis.
Coarctation of the aorta may develop during fetal life and impair quality of life in the adult because upper body hypertension and aneurysm formation in the descending aorta may develop. We used our computational model of the young adult arterial circulation, incorporated aorta coarctation over a range from 0 to 80% and evaluated the effects in terms of forward pressure (P(+)) and backward pressure (P(-)). Predictions at several sites proximal and distal to the coarctation using an impedance-based waveform separation method (WSA) and the time-domain technique of wave intensity analysis (WIA) yielded comparable outcomes. A large reflected backward compression wave was seen proximal to the coarctation. Both techniques, WSA and WIA, gave the same results in terms of P(+) and P(-). A descending index (DI) was formulated as the difference between peak systolic pressure and valve closure pressure, divided by the pulse pressure. DI increased with stenosis severity for mild to moderate aortic coarctations that did not yet cause evident hypertension. This index may allow for early diagnosis by noninvasive estimation of coarctation severity.
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Wijngaard et al. (2008) studied Aortic coarctation. Aortic coarctation (0 to 80% severity) vs. Normal aorta (0% coarctation) was evaluated on Forward and backward pressure waves and Descending Index (DI). In a computational model, wave separation and wave intensity analysis yielded comparable results, and a newly defined Descending Index increased from 0.53 in the normal aorta to 0.96 with 80% coarctation.
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