Correlation analysis of arterial pressure waveform morphology similarity and relative pulse transit time using...

Cardiovascular disease is the leading global cause of death. In arterial health assessment, pressure waveform morphology provides valuable diagnostic information, yet the relationship between waveform changes and physiological parameters remains incompletely understood. To address this gap, this study examines how arterial stiffness (E), heart rate (HR), and stroke volume (SV) affect waveform morphology similarity (WMS) between arterial measurement points and investigates its relationship with relative pulse transit time (RPTT)-pulse transit time normalized by cardiac cycle. Using Cardiovascular hardware simulator and hemodynamic model (pulse pressure mean absolute error = 1.96 ± 1.65 mmHg), each physiological factor's influence was isolated through parametric studies. Results showed E and HR impact waveform morphology, while SV primarily affects pulse pressure magnitude without altering waveform characteristics. Based on these findings, analysis revealed correlations between RPTT and both WMS (experimental Spearman r = -0.982) and pulse pressure amplification ratio (experimental Spearman r = 0.934). Notably, different E-HR combinations yielding similar RPTT values produced nearly identical waveform propagation patterns, establishing RPTT as an integrated indicator of pulse wave dynamics. Leveraging this relationship, the WMS-RPTT relationship was utilized to develop a carotid-femoral pulse wave velocity estimation method tested in a 56-artery numerical model (Pearson r = 0.920, RMSE = 0.65 m/s). This approach may offer potential advantages by incorporating waveform information, suggesting possibilities for non-invasive assessment through peripheral measurements, and potentially contributing to our understanding of pulse wave changes across different physiological conditions, which could enhance arterial hemodynamics insights for cardiovascular risk assessment.