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dc.contributor.authorVennin, Samuel
dc.contributor.authorLi, Ye
dc.contributor.authorMariscal-Harana, Jorge
dc.contributor.authorCharlton, Peter
dc.contributor.authorFok, Henry
dc.contributor.authorGu, Haotian
dc.contributor.authorChowienczyk, Phil
dc.contributor.authorAlastruey, Jordi
dc.date.accessioned2021-11-03T00:30:14Z
dc.date.available2021-11-03T00:30:14Z
dc.date.issued2022-05
dc.identifier.issn0018-9294
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/330206
dc.description.abstractOBJECTIVE: A novel method was presented to separate the central blood pressure wave (CBPW) into five components with different biophysical and temporal origins. It includes a time-varying emission coefficient ( γ) that quantifies pulse wave generation and reflection at the aortic root. METHODS: The method was applied to normotensive subjects with modulated physiology by inotropic/vasoactive drugs (n = 13), hypertensive subjects (n = 158), and virtual subjects (n = 4,374). RESULTS: γ is directly proportional to aortic flow throughout the cardiac cycle. Mean peak γ increased with increasing pulse pressure (from <30 to >70 mmHg) in the hypertensive (from 1.6 to 2.5, P < 0.001) and in silico (from 1.4 to 2.8, P < 0.001) groups, dobutamine dose (from baseline to 7.5 μg/kg/min) in the normotensive group (from 2.1 to 2.7, P < 0.05), and remained unchanged when peripheral wave reflections were suppressed in silico. This was accompanied by an increase in the percentage contribution of the cardiac-aortic-coupling component of CBPW in systole: from 11% to 23% (P < 0.001) in the hypertensive group, 9% to 21% (P < 0.001) in the in silico group, and 17% to 23% (P < 0.01) in the normotensive group. CONCLUSION: These results suggest that the aortic root is a major reflection site in the systemic arterial network and ventricular-aortic coupling is the main determinant in the elevation of pulsatile pulse pressure. SIGNIFICANCE: Ventricular-aortic coupling is a prime therapeutic target for preventing/treating systolic hypertension.
dc.description.sponsorshipThis work was supported by the British Heart Foundation (BHF) [PG/17/50/32903, PG/15/104/31913, FS/20/20/34626], Clinical Research Facility and Biomedical Research Centre at Guy’s and St Thomas’ NHS Foundation Trust (GSTT) in partnership with King’s College London, Wellcome/Engineering Physical Sciences Research Council (EPSRC) Centre for Medical Engineering at King’s College London [WT 203148/Z/16/Z], and National Institute for Health Research (NIHR) BioResource, Department of Health through the National Institute for Health Research (NIHR) Cardiovascular MedTech Co-operative at GSTT. It contributed to the AIM HY (Ancestry and biological Informative Markers in stratification of HYpertension) stratified medicines programme of hypertension funded by the Medical Research Council and the British Heart Foundation.
dc.publisherInstitute of Electrical and Electronics Engineers (IEEE)
dc.rightsAll rights reserved
dc.rights.urihttp://www.rioxx.net/licenses/all-rights-reserved
dc.subjectcardiovascular mechanics
dc.subjecthypertension
dc.subjectpulse wave reflections
dc.subjectaortic root
dc.subjectarterial blood pressure
dc.titleNovel Pressure Wave Separation Analysis for Cardiovascular Function Assessment Highlights Major Role of Aortic Root.
dc.typeArticle
prism.publicationNameIEEE Trans Biomed Eng
dc.identifier.doi10.17863/CAM.77648
dcterms.dateAccepted2021-10-31
rioxxterms.versionofrecord10.1109/TBME.2021.3127799
rioxxterms.versionAM
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/all-rights-reserved
rioxxterms.licenseref.startdate2021-10-31
dc.contributor.orcidCharlton, Peter [0000-0003-3836-8655]
dc.identifier.eissn1558-2531
rioxxterms.typeJournal Article/Review
pubs.funder-project-idBritish Heart Foundation (FS/20/20/34626)
cam.orpheus.successTue Feb 01 19:02:08 GMT 2022 - Embargo updated
cam.orpheus.counter3
rioxxterms.freetoread.startdate2021-11-12


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