4.5 CARDIAC OUTPUT ESTIMATION FROM BEAT-TO-BEAT RADIAL PRESSURE AND PULSE WAVE VELOCITY: A MODEL-BASED STUDY

DOI

10.1016/j.artres.2018.10.044How to use a DOI?

Abstract

Background: Cardiac output (CO) monitoring remains a salient challenge. The state-of-the-art is based on generalized transfer functions and parameter estimations from pooled clinical data, which do not necessarily reflect the state of the cardiovascular system in a patient-specific way. Here, we introduce a patient-specific approach to estimate CO from sequential radial pressure measurements and carotid-to-femoral pulse wave velocity (cf-PWV). We do so by effectively tuning a generalized mathematical model of the cardiovascular system (1).

Methods: Initially, the method uses the measured cf-PWV to estimate arterial compliance. We consequently determine aortic flow from beat-to-beat radial pressure measurements based on the assumption of a fairly constant total peripheral resistance (TPR) over several heartbeats (2). Concretely, we developed an algorithm which, starting from an initial flow, employs a gradient-based optimization process (3) to calculate TPR at each beat. This TPR value is subsequently used as input for a new flow approximation. The process is repeated until convergence is reached. To assess the accuracy of the method, we implemented the algorithm on in vivo anonymized data from n=15 subjects (4) and compared the method-derived CO to the measured ones.

Results: Our results demonstrated that precise estimates of CO were yielded, with a RMSE of 0.38 L/min (Fig. 1). Small variance in arterial compliance tuning did not show to significantly undermine the accuracy of the CO predictions.

Conclusions: The in vivo validation allows us to conclude that our novel method accurately estimates CO in a patient-specific way. Therefore, the technique may potentially be employed for noninvasive CO monitoring in the clinical setting.

Open Access

This is an open access article distributed under the CC BY-NC license.

TY  - JOUR
AU  - Vasiliki Bikia
AU  - Stamatia Pagoulatou
AU  - Theodore G. Papaioannou
AU  - Nikolaos Stergiopulos
PY  - 2018
DA  - 2018/12/04
TI  - 4.5 CARDIAC OUTPUT ESTIMATION FROM BEAT-TO-BEAT RADIAL PRESSURE AND PULSE WAVE VELOCITY: A MODEL-BASED STUDY
JO  - Artery Research
SP  - 76
EP  - 76
VL  - 24
IS  - C
SN  - 1876-4401
UR  - https://doi.org/10.1016/j.artres.2018.10.044
DO  - 10.1016/j.artres.2018.10.044
ID  - Bikia2018
ER  -