Personalized physiologic flow waveforms improve wave reflection estimates compared to triangular flow waveforms in adults

Am J Physiol Heart Circ Physiol. 2021 Mar 12. doi: 10.1152/ajpheart.00747.2020. Online ahead of print.ABSTRACTCentral aortic pressure waveforms contain valuable prognostic information in addition to central systolic pressure. Using pressure-flow relations, wave separation analysis can be used to decompose aortic pressure waveforms into forward- (Pf) and backward-travelling (Pb) components. Reflection magnitude, the ratio of pressure amplitudes (RM=Pb/Pf), is a predictor of heart failure and all-cause mortality. Aortic flow can be measured via Doppler echocardiography or estimated using a triangular flow waveform; however, the latter may underestimate the flow waveform convexity and overestimate Pb and RM. We sought to determine the accuracy of a personalized synthetic physiologic flow waveform, compared to triangular and measured flow waveforms, for estimating wave reflection indices in 49 healthy young (27±6 yrs) and 29 older adults (66±6 yrs; 20 healthy, 9 CKD). Aortic pressure and measured flow waveforms were acquired via radial tonometry and echocardiography, respectively. Triangular and physiologic flow waveforms were constructed from aortic pressure waveforms. Compared to the measured flow waveform, the triangular waveform underestimated Pf in older, but not young, adults and overestimated Pb and RM in both groups. The physiologic waveform was equivalent to measured flow in deriving all wave reflection indices and yielded smaller mean absolute biases than the triangul...
Source: American Journal of Physiology. Heart and Circulatory Physiology - Category: Physiology Authors: Source Type: research