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Wave intensity of aortic root pressure as diagnostic marker of left ventricular systolic dysfunction

Bernhard Hametner1, Stephanie Parragh1,2, Thomas Weber3

  • 1Biomedical Systems, Center for Health & Bioresources, AIT Austrian Institute of Technology GmbH, Vienna, Austria.

Plos One
|June 20, 2017
PubMed

Insights

Pressure-derived parameters and ECG can detect reduced ejection fraction (EF) with high accuracy. This non-invasive method shows promise for cardiovascular risk stratification and screening.

Area of Science:

  • Cardiovascular Physiology
  • Biomedical Engineering
  • Diagnostic Markers

Background:

  • Systolic left ventricular function significantly impacts blood pressure waveforms.
  • Pressure-derived parameters offer potential as non-invasive markers for left ventricular impairment.
  • Electrocardiography (ECG) is a standard tool for cardiac assessment.

Purpose of the Study:

  • To evaluate pressure-based parameters combined with ECG for detecting left ventricular systolic dysfunction.
  • To define left ventricular systolic dysfunction as severely reduced ejection fraction (EF).
  • To assess the diagnostic performance of novel pressure-derived indices.

Main Methods:

  • Analysis of two patient groups: reduced EF and pressure-matched controls.
  • Derivation of central pressure from radial readings to compute blood flow.
  • Application of pulse wave analysis and wave intensity analysis, calculating the ratio of forward intensity peaks (SDR) as a novel index.

Main Results:

  • SDR was significantly lower in the reduced EF group (2.5 vs. 4.4, P<0.001).
  • Reduced EF group also showed lower central pulse pressure, augmentation index, and ejection duration (ED), with prolonged QRS duration.
  • A decision tree using SDR, ED, and QRS duration achieved 92% sensitivity and 80% specificity for detecting reduced EF.

Conclusions:

  • Pressure-derived parameters are feasible for indicating reduced ejection fraction.
  • These parameters may enhance cardiovascular risk stratification quality.
  • Potential application in screening strategies for the general population.
Abstract

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