Determination of Aortic Characteristic Impedance and Total Arterial Compliance From Regional Pulse Wave Velocities Using Machine Learning: An in-silico Study

Bikia, Vasiliki; Rovas, Georgios; Pagoulatou, Stamatia; Stergiopulos, Nikolaos

doi:10.3389/fbioe.2021.649866

Cited by 16 publications

(15 citation statements)

References 75 publications

(92 reference statements)

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“…The total arterial compliance and PWV are often measured in a clinical setting and they are preferred by physicians over the direct estimation of the local aortic compliance. They are associated with the arterial stiffness and the pulsatile arterial load that the heart encounters during ejection, while they are used as powerful biomarkers and predictors of cardiovascular risk 33,34 .…”

Section: Methodsmentioning

confidence: 99%

In vivo evaluation of a novel compliance-matching vascular graft

Rovas,

Reymond,

van Steenberghe

et al. 2023

Preprint

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BackgroundThe mismatch of elastic properties between the arterial tissue and the vascular grafts, commonly called compliance mismatch, is responsible for many deleterious post-operative complications. Currently, there is an absence of prostheses that conform with the compliance of healthy aortas.ObjectivesWe proposed a novel compliance-matching graft design, composed of a standard aortic graft surrounded by an optimized Nickel-Titanium compliance-augmenting layer. We aimed to evaluate the in vivo performance of the novel grafts in a swine model and compare it to the native aorta and to gold-standard aortic grafts.MethodsWe replaced the thoracic aorta of six domestic pigs with compliance-matching grafts under cardiopulmonary bypass. We removed the compliance-regulating layer of the compliant grafts, so that gold-standard grafts remained implanted.ResultsThe compliance-matching grafts were implanted without surgical complications and without inducing post-operative hypertension by maintaining systolic pressure (11% increase), aortic pulse wave velocity (17% decrease) and aortic distensibility (40% increase) at healthy levels. The gold-standard grafts caused a significant rise in systolic pressure (47%), pulse pressure (126%) and pulse wave velocity (64%).ConclusionsOur novel compliant grafts could diminish the complications caused by compliance-mismatch and they could surpass the clinical performance of existing prostheses. The proposed grafts comprise a step towards optimized treatment and improved life expectancy of patients subjected to aortic replacement.

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Section: Methodsmentioning

confidence: 99%

In vivo evaluation of a novel compliance-matching vascular graft

Rovas,

Reymond,

van Steenberghe

et al. 2023

Preprint

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“…12 Furthermore, LVEDVI and LVESVI are strong prognostic indicators of mortality, while increased central aortic stiffening is associated with the development of HF and can be measured through aortic characteristic impedance. 13 In combination, these measures provide insight into the underlying mechanism of sacubitril/valsartan, specifically its effects on reverse remodeling. Several studies, most notably the PROVE-HF and EVALUATE-HF trials, have been conducted to delineate the mechanisms by which the ARNI, sacubitril/valsartan, improves outcomes in patients with HFrEF (Table 1).…”

Section: Under S Tanding Mechanis Tic Propertie Smentioning

confidence: 99%

“…These may be demonstrated by measuring the change in cardiac volume and function through LV end‐diastolic and LV end‐systolic volumes indexed by body surface area, known as LVEDVI and LVESVI, respectively 12 . Furthermore, LVEDVI and LVESVI are strong prognostic indicators of mortality, while increased central aortic stiffening is associated with the development of HF and can be measured through aortic characteristic impedance 13 . In combination, these measures provide insight into the underlying mechanism of sacubitril/valsartan, specifically its effects on reverse remodeling.…”

Section: Understanding Mechanistic Propertiesmentioning

confidence: 99%

Evaluating the evidence for sacubitril/valsartan across the continuum of heart failure

et al. 2022

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Since initial publication of the PARADIGM‐HF trial in 2014, sacubitril/valsartan has been investigated in various settings to establish optimal use, further expanding its indications in patients with heart failure (HF). Although numerous studies have been published, until recently these have primarily involved post hoc analyses from the PARADIGM‐HF study itself with a consistent focus on use of sacubitril/valsartan in patients with HF with reduced ejection fraction (HFrEF). This has led to a gap in the literature regarding utility of sacubitril/valsartan in other HF subpopulations. The aim of this review is to provide a summary of recent clinical trials further expanding use and guideline recommendations for sacubitril/valsartan. The findings of 15 studies, including clinical trials and post hoc analyses, are summarized and describe the use of sacubitril/valsartan in additional HF subpopulations, such as HFrEF following hospitalization for acute decompensated HF and advanced HF, HF with preserved ejection fraction (HFpEF), and HF postmyocardial infarction. In addition, three studies investigating timing of initiation, dose titration regimens, and cost‐effectiveness are examined. Select ongoing trials are also reviewed to demonstrate the continued commitment to further advance care of patients with HF. This comprehensive review serves as a resource for health care providers who pursue optimal utilization of sacubitril/valsartan in their respective clinical practices.

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“…In this study, we introduced a novel machine learning-enabled method to estimate CO from radial BP waveform. Given that simultaneous invasive radial BP and CO data are typically difficult to acquire in vivo , we leveraged a previously generated in silico dataset simulating 3,818 virtual subjects ( Bikia et al, 2021 ). A training/testing pipeline using artificial neural networks (ANN) was adopted for the development of two ANN models using as an input vector: (i) the calibrated radial BP waveform, or (ii) the uncalibrated radial BP waveform.…”

Section: Introductionmentioning

confidence: 99%

Cardiac output estimated from an uncalibrated radial blood pressure waveform: validation in an in-silico-generated population

Bikia

Rovas

Stergiopulos

2023

Front. Bioeng. Biotechnol.

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Background: Cardiac output is essential for patient management in critically ill patients. The state-of-the-art for cardiac output monitoring bears limitations that pertain to the invasive nature of the method, high costs, and associated complications. Hence, the determination of cardiac output in a non-invasive, accurate, and reliable way remains an unmet need. The advent of wearable technologies has directed research towards the exploitation of wearable-sensed data to improve hemodynamical monitoring.Methods: We developed an artificial neural networks (ANN)-enabled modelling approach to estimate cardiac output from radial blood pressure waveform. In silico data including a variety of arterial pulse waves and cardiovascular parameters from 3,818 virtual subjects were used for the analysis. Of particular interest was to investigate whether the uncalibrated, namely, normalized between 0 and 1, radial blood pressure waveform contains sufficient information to derive cardiac output accurately in an in silico population. Specifically, a training/testing pipeline was adopted for the development of two artificial neural networks models using as input: the calibrated radial blood pressure waveform (ANNcalradBP), or the uncalibrated radial blood pressure waveform (ANNuncalradBP).Results: Artificial neural networks models provided precise cardiac output estimations across the extensive range of cardiovascular profiles, with accuracy being higher for the ANNcalradBP. Pearson’s correlation coefficient and limits of agreement were found to be equal to [0.98 and (−0.44, 0.53) L/min] and [0.95 and (−0.84, 0.73) L/min] for ANNcalradBP and ANNuncalradBP, respectively. The method’s sensitivity to major cardiovascular parameters, such as heart rate, aortic blood pressure, and total arterial compliance was evaluated.Discussion: The study findings indicate that the uncalibrated radial blood pressure waveform provides sample information for accurately deriving cardiac output in an in silico population of virtual subjects. Validation of our results using in vivo human data will verify the clinical utility of the proposed model, while it will enable research applications for the integration of the model in wearable sensing systems, such as smartwatches or other consumer devices.

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Determination of Aortic Characteristic Impedance and Total Arterial Compliance From Regional Pulse Wave Velocities Using Machine Learning: An in-silico Study

Cited by 16 publications

References 75 publications

In vivo evaluation of a novel compliance-matching vascular graft

In vivo evaluation of a novel compliance-matching vascular graft

Evaluating the evidence for sacubitril/valsartan across the continuum of heart failure

Cardiac output estimated from an uncalibrated radial blood pressure waveform: validation in an in-silico-generated population

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