Systemic Analysis of Blood Pressure Waveform Features Using a Cardiovascular Simulator: Implications for Non-invasive...

Blood pressure waveform analysis offers valuable insights into cardiovascular health, yet the complex interrelationships between waveform features and specific cardiovascular parameters remain incompletely understood. This study presents a systematic analysis of blood pressure waveform features using a validated cardiovascular simulator that accurately replicates pulse wave reflection phenomena and non-linear vascular mechanics. By precisely controlling key cardiovascular parameters-vascular elasticity, stroke volume, peripheral resistance, and heart rate-within physiologically realistic ranges, the independent effects of each parameter on waveform morphology were quantified. The simulator-based approach uniquely enabled exploration across the entire physiological spectrum, incorporating non-linear relationships that would be difficult to observe in traditional clinical studies. Sensitivity and stability analyses identified specific features highly responsive to vascular elasticity changes, with DownSlope and pulse pressure (PP) demonstrating both high sensitivity and stability. Clinical validation using waveform data from 78 human subjects confirmed that simulator-derived sensitivity patterns were observable in actual human waveforms, particularly the strong correlation between DownSlope and vascular elasticity as measured by pulse wave velocity. This physics-informed approach to feature selection provides valuable insights for non-invasive cardiovascular health monitoring applications and establishes a foundation for more interpretable and reliable machine learning models in cardiovascular assessment.Clinical Relevance- This enables clinicians to more accurately interpret pressure waveforms by providing clearer understanding of how elemental cardiovascular parameter changes are reflected on waveform features.