A noninvasive method of estimating patient-specific left ventricular pressure waveform
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Jun Liu1, Liling Hao2, Frans van de Vosse3
1College of Medicine and Biological Information Engineering, Northeastern University, Shenyang 110169, China; Department of Biomedical Engineering, China Medical University, Shenyang 110122, China.
Insights
A new noninvasive method estimates left ventricular pressure waveforms in coronary artery disease (CAD) patients. This approach simplifies calculations and accurately predicts key pressure metrics, offering a valuable clinical tool.
Area of Science:
- Cardiovascular Physiology
- Biomedical Engineering
- Medical Imaging Analysis
Background:
- Left ventricular pressure waveform is crucial for assessing coronary artery disease (CAD).
- Previous noninvasive methods struggled to accurately estimate this waveform in CAD patients.
- Accurate estimation is vital for understanding cardiac function in CAD.
Purpose of the Study:
- To develop a patient-specific, noninvasive method for estimating left ventricular pressure waveforms.
- To overcome limitations of previous methods in CAD patient populations.
- To provide a reliable surrogate for invasive pressure measurements.
Main Methods:
- Utilized a simplified systemic circulation model with a single fiber model and 1D arterial tree simulation.
- Employed Morris method for sensitivity analysis to identify key model parameters.
- Developed a two-step process to identify parameter subsets and estimate the left ventricular pressure waveform using peripheral artery pressure.
Main Results:
- Reduced computational cost and simplified parameter identification through subset selection.
- Achieved good correlation with reference left ventricular pressure waveforms in CAD patients.
- Reported high correlation coefficients (r=0.907 for systolic, r=0.904 for pulse, r=0.780 for mean blood pressure).
Conclusions:
- The proposed method offers a convenient and accurate noninvasive surrogate for estimating left ventricular pressure waveforms.
- This technique has the potential to improve the noninvasive assessment of cardiac function in CAD.
- Further validation may establish this method as a standard clinical tool.
Background And Objective:
The left ventricular pressure waveform is indispensable for the construction of the pressure strain loop when investigating coronary artery disease (CAD) patients. In previous studies by others, exclusion of CAD patients has not allowed a reliable estimation of the left ventricular pressure waveform from the pressure strain loop of these patients. To remedy this, we propose a patient-specific noninvasive method for the estimation of left ventricular pressure.
Methods:
A simplified systemic circulation model consisting primarily of a single fiber model and a 1D simulation of the arterial tree was used. Sensitivity analysis based on the Morris method was performed to select a subset of the important parameters. Following this, the important parameter subset and the set of all the parameters were identified in the model using the pressure waveform of a peripheral artery as input, in a two-step process. In addition, the left ventricular pressure waveform was estimated using the set of all parameters.
Results:
Reducing the size of the parameter subset significantly decreases the computational cost of parameter optimization in the first step and greatly simplifies the identification of the full parameter set in the second step. Comparison with the reference left ventricular pressure waveform from CAD patients, showed that the proposed method provides a good estimate of the reference left ventricular pressure waveform. The correlation coefficients between the estimated and reference were r = 0.907, r = 0.904 and r = 0.780 for systolic blood pressure, pulse pressure and mean blood pressure, respectively.
Conclusions:
This work may provide a convenient surrogate for the estimation of the left ventricular pressure waveform.
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