Arterial path length estimation for heart-to-brachium pulse wave velocity

Area of Science:

• Cardiovascular Physiology
• Biomedical Engineering
• Medical Imaging

Background:

• Aortic stiffness is a key indicator of cardiovascular health.
• Heart-brachial pulse wave velocity (hbPWV) is a novel measure of proximal aortic stiffness.
• Accurate measurement of arterial path length (Lhb) is crucial for hbPWV calculation.

Purpose of the Study:

• To propose and validate a simple formula for estimating Lhb.
• To enable accurate calculation of hbPWV using estimated Lhb.
• To improve the clinical utility of hbPWV measurement.

Main Methods:

• Reference Lhb was measured using 3D MRI in 190 patients (aged 19-79).
• Estimation formulae for Lhb were developed using multiple regression analysis (age, sex, height).
• hbPWV was calculated using estimated Lhb and the time interval from the second heart sound to the brachial dicrotic notch.

Main Results:

• Estimated Lhb by sex and height showed strong correlation (r=0.969) and accuracy with MRI-based Lhb.
• Estimated Lhb by age, sex, and height showed even greater correlation (r=0.976) and accuracy.
• The proposed simple equation accurately evaluated hbPWV, outperforming other methods with significant biases.

Conclusions:

• A simple, validated formula effectively estimates Lhb for hbPWV calculation.
• This method provides accurate hbPWV measurements, enhancing its clinical applicability.
• The findings support the use of estimated Lhb for routine hbPWV assessment.