Improved estimation of cardiac power output by including pulsatile power

Jozwiak, Mathieu; Teboul, Jean–Louis; Millasseau, Sandrine; Petitjean, Michel; Francs, Claire Colas Des; Roisman, Gabriel; Chemla, Denis

doi:10.1016/j.bja.2020.05.010

Cited by 5 publications

(1 citation statement)

References 8 publications

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“…The aortic PP is calculated as aortic SBP minus aortic DBP; the MAP is calculated as double aortic DBP plus aortic SBP, then divided by 3; the pulsatile load is defined as the ratio of aortic PP/MAP [29]. The Ea is commonly approximated by the steady-state LVESP-to-SV ratio, where LVESP is the LV end-systolic pressure; and the LVESP almost equals to 0.9 × aortic SBP [30].…”

Section: Echocardiography and Calculationsmentioning

confidence: 99%

Noninvasive Assessment of Sex Differences in Arterial Load in Healthy Adults

Yin

2022

Artery Res

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Background Women have higher risk of heart failure than their male counterparts. Although the mechanical inefficiency of myocardium against an excessive afterload is an important reason of heart failure, little attention has been paid to the sex differences in arterial load and its clinical relevance. Results The effective arterial elastance index (EaI), total arterial compliance index (TACI), and systemic vascular resistance index (SVRI) were determined using transthoracic echocardiography combined with cuff-measured brachial blood pressure in 460 healthy adults (230 men). The sex differences in these arterial load indexes were analyzed. No statistical difference was found in the age, heart rate, and stroke volume index (all P < 0.05). After adjustment for the cuff-measured blood pressure; the estimated marginal means (95% CIs) of the EaI was higher in women than in men [0.972 (0.952–0.991) vs 0.743 (0.724–0.763) mmHg m2/mL, P < 0.001], the TACI was lower in women than in men [0.924 (0.905–0.944) vs 1.055 (1.036–1.075) mL/mm Hg m2, P < 0.001], and no statistical difference was found in the SVRI between sexes (P > 0.05). Conclusions For any given cuff-measured blood pressure, greater integrated and pulsatile arterial load are imposed on left ventricle in women than in men, which is a piece of evidence that women have higher risk of heart failure than their counterparts.

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Section: Echocardiography and Calculationsmentioning

confidence: 99%

Noninvasive Assessment of Sex Differences in Arterial Load in Healthy Adults

Yin

2022

Artery Res

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Patient-Specific Haemodynamic Analysis of Virtual Grafting Strategies in Type-B Aortic Dissection: Impact of Compliance Mismatch

Girardin

Stokes

Thet

et al. 2023

Preprint

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IntroductionCompliance mismatch between the aortic wall and Dacron Grafts is a clinical problem concerning aortic haemodynamics and morphological degeneration. The aortic stiffness introduced by grafts can lead to an increased left ventricular (LV) afterload. This study quantifies the impact of compliance mismatch by virtually testing different Type-B aortic dissection (TBAD) surgical grafting strategies in patient-specific, compliant computational fluid dynamics (CFD) simulations.Materials and MethodsA post-operative case of TBAD was segmented from computed tomography angiography data. Three virtual surgeries were generated using different grafts; two additional cases with compliant grafts were assessed. Compliant CFD simulations were performed using a patient-specific inlet flow rate and three-element Windkessel outlet boundary conditions informed by 2D-Flow Magnetic Resonance Imaging (2DMRI) data. The wall compliance was calibrated using Cine-MRI images. Pressure, wall shear stress (WSS) indices and energy loss (EL) were computed.ResultsIncreased aortic stiffness and longer grafts increased aortic pressure and EL. Implementing a compliant graft matching the aortic compliance of the patient reduced the pulse pressure by 11% and EL by 4%. The endothelial cell activation potential (ECAP) differed the most within the aneurysm, where the maximum percentage difference between the reference case and the mid (MDA) and complete (CDA) descending aorta replacements increased by 16% and 20%, respectively.ConclusionThis study highlights the negative impact of increased graft length on LV condition after surgical aortic replacement in TBAD. To mitigate the associated risks to the patient, graft manufacturers should allocate more resources toward developing compliant biomimetic grafts.

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