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Impact of varying diastolic pressure fitting technique for the reservoir-wave model on wave intensity analysis
Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine ( IF 1.7 ) Pub Date : 2020-09-30 , DOI: 10.1177/0954411920959957
Nicola Pomella 1, 2, 3 , Ernst R Rietzschel 4 , Patrick Segers 5 , Ashraf William Khir 1
Affiliation  

The reservoir-wave model assumes that the measured arterial pressure is made of two components: reservoir and excess. The effect of the reservoir volume should be excluded to quantify the effects of forward and backward traveling waves on blood pressure. Whilst the validity of the reservoir-wave concept is still debated, there is no consensus on the best fitting method for the calculation of the reservoir pressure waveform. Therefore, the aim of this parametric study is to examine the effects of varying the fitting technique on the calculation of reservoir and excess components of pressure and velocity waveforms. Common carotid pressure and flow velocity were measured using applanation tonometry and doppler ultrasound, respectively, in 1037 healthy humans collected randomly from the Asklepios population, aged 35 to 55 years old. Different fitting techniques to the diastolic decay of the measured arterial pressure were used to determine the asymptotic pressure decay, which in turn was used to determine the reservoir pressure waveform. The corresponding wave speed was determined using the PU-loop method, and wave intensity parameters were calculated and compared. Different fitting methods resulted in significant changes in the shape of the reservoir pressure waveform; however, its peak and time integral remained constant in this study. Although peak and integral of excess pressure, velocity components and wave intensity changed significantly with changing the diastolic decay fitting method, wave speed was not substantially modified. We conclude that wave speed, peak reservoir pressure and its time integral are independent of the diastolic pressure decay fitting techniques examined in this study. Therefore, these parameters are considered more reliable diagnostic indicators than excess pressure and velocity which are more sensitive to fitting techniques.



中文翻译:

储层波模型的不同舒张压拟合技术对波强度分析的影响

储库波模型假设测量的动脉压由两个部分组成:储库压和过量动脉压。应排除储库容积的影响以量化前向和后向行波对血压的影响。虽然储层波概念的有效性仍有争议,但对于计算储层压力波形的最佳拟合方法尚未达成共识。因此,本参数研究的目的是检查不同拟合技术对储层计算以及压力和速度波形多余分量的影响。分别使用压平眼压计和多普勒超声测量了从 Asklepios 人群中随机收集的 1037 名年龄在 35 至 55 岁之间的健康人的颈总动脉压力和流速。使用对测量的动脉压的舒张期衰减的不同拟合技术来确定渐近压力衰减,进而使用渐近压力衰减来确定储层压力波形。采用PU-loop方法确定相应的波速,计算并比较波强参数。不同的拟合方法导致储层压力波形形状发生明显变化;然而,在本研究中,其峰值和时间积分保持不变。虽然随着舒张期衰减拟合方法的改变,超压的峰值和积分、速度分量和波强度发生了显着变化,但波速并未发生实质性改变。我们得出的结论是,波速、峰值储层压力及其时间积分与本研究中检查的舒张压衰减拟合技术无关。因此,这些参数被认为比对拟合技术更敏感的超压和速度更可靠的诊断指标。

更新日期:2020-09-30
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