Analysis of Aortic Wave Travel and Reflection Using Advanced Modeling Methods in Simplified Geometries

Abstract

The analysis of wave travel and reflection has gained increased interest in the clinical community. The speed of the pressure pulse, PWV, (assessed from the time delay of the foot of the wave measured at two distant locations), is considered the gold standard method to assess the stiffness of arterial segments and has been shown to be of prognostic value for cardiovascular disease. Also, analysis of wave reflections has been suggested as diagnostic tool, a.o. to estimate the effect of the treatment of aortic coarctation (a congenital disease characterized by an obstructive narrowing of the upper descending aorta) on the load on the heart. The presence of a residual narrowing and/or local stiffening after treatment of aortic coarctation leads to an impedance mismatch and generates wave reflections that reach the heart very fast, given the short distance to the heart. The exact interplay between arterial stiffness, wave travel and reflection is, however, still relatively poorly understood due to the complexity of the arterial tree leading to scattered wave reflection, rather than discrete reflection.