A three-segment transmission line model showed a higher distal reflection coefficient in CAD patients (0.85) versus controls (0.71; P<0.05), preserving discriminatory information.
Observational (n=61)
Does an individualized aorto-radial pressure transfer function model improve the reconstruction of carotid pressure waveforms compared to averaged transfer functions in patients with CAD and controls?
Averaged transfer functions yield significant discrepancies between reconstructed and measured pressure waveforms, though different transfer functions preserve the information that discriminates between controls and CAD patients.
Absolute Event Rate: 0.85% vs 0.71%
p-value: p=< 0.05
We fitted a three-segment transmission line model for the radial-carotid/aorta pressure transfer function (TFF) in 31 controls and 30 patients with coronary artery disease using noninvasively measured (tonometry) radial and carotid artery pressures (P(car)). Except for the distal reflection coefficient (0.85 +/- 0.21 in patients vs. 0.71 +/- 0.25 in controls; P < 0.05), model parameters were not different between patients or controls. Parameters were not related to blood pressure, age, or heart rate. We further assessed a point-to-point averaged TFF (TFF(avg)) as well as upper (TFF(max)) and lower (TFF(min)) enveloping TFF. Pulse pressure (PP) and augmentation index (AIx) were derived on original and reconstructed P(car) (P(car,r)). TFF(avg) yielded closest morphological agreement between P(car) and P(car,r) (root mean square = 4.3 +/- 2.3 mmHg), and TTF(avg) best predicted PP (41.5 +/- 11.8 vs. 41.1 +/- 10.0 mmHg measured) and AIx (-0.02 +/- 0.19 vs. 0.01 +/- 0.19). PP and AIx, calculated from P(car) or P(car,r), were higher in patients than in controls, irrespectively of the TFF used. We conclude that 1) averaged TFF yield significant discrepancies between reconstructed and measured pressure waveforms and subsequent derived AIx; and 2) different TFFs seem to preserve the information in the pressure wave that discriminates between controls and patients.
Segers et al. (Tue,) conducted a observational in Coronary artery disease (n=61). Three-segment transmission line model for pressure transfer function vs. Healthy controls was evaluated on Distal reflection coefficient (p=< 0.05). A three-segment transmission line model showed a higher distal reflection coefficient in CAD patients (0.85) versus controls (0.71; P<0.05), preserving discriminatory information.
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