Noninvasive computerized assessment of left ventricular performance and systemic hemodynamics by study of aortic root pressure and flow estimates in healthy men, and men with acute and healed myocardial infarction

Aakhus, Svend; Soerlie, Carsten; Faanes, Audun; Hauger, Svein O.; Bjoernstad, Knut; Hatloe, Liv; Angelsen, B. A. J.

doi:10.1016/0002-9149(93)90670-8

Cited by 17 publications

(9 citation statements)

References 29 publications

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“…14,15 These methods are based on measurement of pressure and flow, ideally measured simultaneously and at the same anatomic location, preferentially the central aorta. 16 Although approximated approaches, based on aortic flow and carotid 17 or subclavian 18 pressure measurements, are feasible, implementation of these extended measurement protocols in a clinical setting is not evident. In an attempt to merge the benefits of a method based on measurement of pressure waveform alone and of the wave separation analysis, Westerhof et al 8 recently advocated a new method, where the flow wave is approximated by a triangle.…”

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confidence: 99%

Evaluation of Noninvasive Methods to Assess Wave Reflection and Pulse Transit Time From the Pressure Waveform Alone

et al. 2009

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Abstract-Accurate quantification of pressure wave reflection requires separation of pressure in forward and backward components to calculate the reflection magnitude as the ratio of the amplitudes backward and forward pressure. To do so, measurement of aortic flow in addition to the pressure wave is mandatory, a limitation that can be overcome by replacing the unknown flow wave by an (uncalibrated) triangular estimate. Another extended application of this principle is the derivation of aortic pulse transit time from a single pulse recording. We verified these approximation techniques for reflection magnitude and transit time using carotid pressure and aortic flow waveforms measured noninvasively in the Asklepios Study (Ͼ2500 participants; 35 to 55 years of age). A triangular flow approximation using timing information from the measured aortic flow waveform yielded moderate agreement between reference and estimated reflection magnitude (R 2 ϭ0.55). Approximating the flow by a more physiological waveform significantly improved these results (R 2 ϭ0.74). Aortic transit time was assessed using pressure and measured or approximated flow waveforms, and results were compared with carotid-femoral transit times measured by Doppler ultrasound. Agreement between estimated and reference transit times was moderate (R 2 Ͻ0.29). Both for reflection magnitude and transit time, agreement between reference and approximated values further decreased when the approximated flow waveform was obtained using timing information from the pressure waveform. We conclude that, in our Asklepios population, results from pressure-based approximative methods to derive reflection magnitude or aortic pulse transit time differ substantially from the values obtained when using both measured pressure and flow information. Key Words: hypertension Ⅲ blood pressure measurement/monitoring Ⅲ hemodynamics Ⅲ arterial stiffness Ⅲ wave reflection Ⅲ pulse wave velocity T he pressure pulse can be considered as the composite of a forward pressure wave, traveling from the heart to the periphery, and of a reflected pressure wave, traveling backward toward the heart. Early return of this reflected wave boosts (central) systolic blood pressure, increasing the load on the heart and boosting the amplitude of the pressure pulse, factors that have been shown to increase cardiovascular risk. [1][2][3][4] Therefore, analysis of pulse wave velocity and pressure wave reflection have been points of clinical interest for many years now.Several methods to quantify wave reflection emerged, 5 the most widespread probably being the augmentation index (AIx). 6,7 AIx is a parameter based on analysis of the pressure waveform and expresses the ratio of augmented pressure (attributed to wave reflection) to pulse pressure. However, because several factors influence its value, 8 -12 AIx might not be the most appropriate parameter for an accurate quantification of the magnitude of wave reflection. 13 More accurate methods to assess wave reflection are based on wave separation analysis....

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Evaluation of Noninvasive Methods to Assess Wave Reflection and Pulse Transit Time From the Pressure Waveform Alone

et al. 2009

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“…The setup has previously been described [9]. An ultrasound scan ner (CFM 750, Vingmed Sound A/S, Horten.…”

Section: Noninvasive Data Acquisitionmentioning

confidence: 99%

“…1). An estimate of the aortic root pressure curve was obtained by calibrating the pulse trace with brachial artery pressures [10][11][12], The calibrated pulse tracing and the manually traced (maxi mum velocities) Doppler velocity curve were then processed using specially designed computer software [9] where the pulse tracing was corrected for pulse transmission time from the aortic root to the sub clavian artery by alignment of the pulse tracing incisura to the end systole (i.e. valve closure click) on the Doppler recording.…”

Section: Data Analysis O F Noninvasive Measurementsmentioning

confidence: 99%

“…aortic) resistance to rapid volume expansion during left ventricular ejection. We have developed a mathematical procedure for estimat ing the parameters from this model as previously described [9], Brief ly, input (i.e. aortic root) pressure and flow data are used to obtain initial estimates of the 3 parameters.…”

Section: Estimation O F Arterial Distensibilitymentioning

confidence: 99%

“…The extended windkcsscl model [7] comprises 3 parameters: peripheral resistance, compliance, and characteristic im pedance. This model has proven useful in evaluating the human systemic circulation [8], The present study uses noninvasive measurements of aortic root pressure and flow as the basis for estimating the parameters of this model [9],…”

Section: Introductionmentioning

confidence: 99%

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Systemic Arterial Compliance Early and Late after a First Acute Myocardial Infarction

Aakhus

Bjørnstad²,

Soma³

et al. 1996

Cardiology

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Systemic arterial properties and left ventricular function were assessed by Doppler echocardiography and a calibrated subclavian artery pulse tracing early (5 weeks) and late (27 months) after a first acute myocardial infarction in 19 patients aged 44-77 years and in healthy subjects matched for age, gender, and arterial blood pressure. Total arterial compliance (3-element windkessel model) was reduced by 26% (p < 0.001) from early to late assessment, and left-ventricular end-diastolic and end-systolic volumes were increased by 11 and 18%, respectively (p < 0.05). Peripheral resistance and characteristic impedance were not significantly changed. The healthy matched subjects had arterial compliance similar to patients at early assessment, but tended to be higher at late. Thus, 2.3 years after a first acute myocardial infarction with moderate left ventricular dilatation, arterial distensibility was significantly decreased whereas peripheral resistance was not changed.

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Altered maternal left ventricular contractility and function during normal pregnancy

Estensen

Beitnes

Grindheim

et al. 2013

Ultrasound Obstet Gynecol

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Objectives To evaluate maternal left ventricular (LV) systolic and diastolic function during normal pregnancy by non-invasive measures of LV contractility incorporating loading conditions.Methods Sixty-five women were examined using echocardiography, including tissue Doppler and two-dimensional speckle tracking, and subclavian artery pulse trace recordings at gestational weeks 14-16, 22-24 and 36, and at 6 months postpartum. ResultsThe mean ± SD age of the women was 32.0 ± 4.6 years. Cardiac output and LV end-diastolic volume were on average 20% and 23% higher, respectively, during pregnancy, compared

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Noninvasive computerized assessment of left ventricular performance and systemic hemodynamics by study of aortic root pressure and flow estimates in healthy men, and men with acute and healed myocardial infarction

Cited by 17 publications

References 29 publications

Evaluation of Noninvasive Methods to Assess Wave Reflection and Pulse Transit Time From the Pressure Waveform Alone

Evaluation of Noninvasive Methods to Assess Wave Reflection and Pulse Transit Time From the Pressure Waveform Alone

Systemic Arterial Compliance Early and Late after a First Acute Myocardial Infarction

Altered maternal left ventricular contractility and function during normal pregnancy

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