Estimating arterial resistance and compliance during transient conditions in humans.

Abstract

Almost all existing methods for estimating hemodynamic parameters are valid only during steady-state conditions. There is often a need, however, for estimating peripheral resistance and total arterial compliance during beat-to-beat transients such as during atrial fibrillation. During such transients the pressure at the onset and end of a cardiac cycle usually differ. This pressure difference necessitates a modification of usual methods used for estimating these hemodynamic parameters. In this paper we formulate a method for estimating resistance and total arterial compliance during such beat-to-beat transients. For simplicity the expressions are derived for a two-element windkessel model of the circulation. The method is a generalization of one we previously proposed. Rather than using parameter estimation techniques or having to assume a monoexponential pressure decay during diastole, our method uses the areas under the systolic and diastolic portions of the aortic pressure versus time tracing to obtain explicit expressions for compliance; both for the case where it is constant and when it is assumed to be nonlinear (exponential) function of pressure. Aortic pressure and flow data from patients undergoing cardiac catheterization are employed to illustrate the method. Results illustrate the quantitative difference between uncorrected and corrected estimates of both resistance and compliance as a function of the pressure difference between the onset and end of each beat. The uncorrected parameters were found to be linearly and highly correlated with these pressure differences. Regressions of pressure difference against normalized values revealed that the pooled data for all patients defined a single relationship.(ABSTRACT TRUNCATED AT 250 WORDS)