Abstract
The arterial pulse wave (PW) is a rich source of information on cardiovascular (CV) health. It is widely measured by both consumer and clinical devices. However, the physical determinants of the PW are not yet fully understood, and the development of PW analysis algorithms is limited by a lack of PW data sets containing reference CV measurements. Our aim was to create a database of PWs simulated by a computer to span a range of CV conditions, representative of a sample of healthy adults. The typical CV properties of 25–75 yr olds were identified through a literature review. These were used as inputs to a computational model to simulate PWs for subjects of each age decade. Pressure, flow velocity, luminal area, and photoplethysmographic PWs were simulated at common measurement sites, and PW indexes were extracted. The database, containing PWs from 4,374 virtual subjects, was verified by comparing the simulated PWs and derived indexes with corresponding in vivo data. Good agreement was observed, with well-reproduced age-related changes in hemodynamic parameters and PW morphology. The utility of the database was demonstrated through case studies providing novel hemodynamic insights, in silico assessment of PW algorithms, and pilot data to inform the design of clinical PW algorithm assessments. In conclusion, the publicly available PW database is a valuable resource for understanding CV determinants of PWs and for the development and preclinical assessment of PW analysis algorithms. It is particularly useful because the exact CV properties that generated each PW are known.NEW & NOTEWORTHY First, a comprehensive literature review of changes in cardiovascular properties with age was performed. Second, an approach for simulating pulse waves (PWs) at different ages was designed and verified against in vivo data. Third, a PW database was created, and its utility was illustrated through three case studies investigating the determinants of PW indexes. Fourth, the database and tools for creating the database, analyzing PWs, and replicating the case studies are freely available.
Highlights
The arterial pulse wave (PW) is used for physiological assessment in both clinical medicine and consumer devices
There are marked differences between PWs at different sites, such as the increase in systolic pressure and the transition from an A- to C-type pressure wave shape with distance from the aortic root [108]; the genesis of a diastolic peak in U in the limbs, which is accompanied by diastolic peaks in the other PWs at limb sites; and the genesis of a second systolic peak in U at the carotid artery, accompanied by second systolic peaks in A and PPG PWs at the temporal artery, which bifurcates from the carotid artery
A total of 537 out of the 4,374 virtual subjects exhibited blood pressure (BP) outside of healthy ranges. This was predominantly due to abnormal pulse pressure (PP) and abnormally high PP amplification (PPamp) (90 of the remainder)
Summary
The arterial pulse wave (PW) is used for physiological assessment in both clinical medicine and consumer devices. The PW contains a wealth of information on the cardiovascular (CV) system [4] It is influenced by the heart, with properties such as heart rate (HR) and stroke volume (SV) influencing its duration and morphology, and the vasculature, with arterial stiffness and wave reflections influencing its morphology. The PW can be measured using noninvasive clinical devices, such as oscillometric blood pressure (BP) monitors and pulse oximeters. It is routinely monitored by consumer devices, such as smart watches and fitness wristbands [27]. There is scope for obtaining great insight into CV function from the PW in clinical settings and daily life
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