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A Technical Assessment of Pulse Wave Velocity Algorithms Applied to Non-invasive Arterial Waveforms

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Abstract

Non-invasive assessment of arterial stiffness through pulse wave velocity (PWV) analysis is becoming common clinical practice. However, the effects of measurement noise, temporal resolution and similarity of the two waveforms used for PWV calculation upon accuracy and variability are unknown. We studied these effects upon PWV estimates given by foot-to-foot, least squared difference, and cross-correlation algorithms. We assessed accuracy using numerically generated blood pressure and flow waveforms for which the theoretical PWV was known to compare with the algorithm estimates. We assessed variability using clinical measurements in 28 human subjects. Wave shape similarity was quantified using a cross correlation-coefficient (CCCoefficient), which decreases with increasing distance between waveform measurements sites. Based on our results, we propose the following criteria to identify the most accurate and least variable algorithm given the noise, resolution and CCCoefficient of the measured waveforms. (1) Use foot-to-foot when the noise-to-signal ratio ≤10%, and/or temporal resolution ≥100 Hz. Otherwise (2) use a least squares differencing method applied to the systolic upstroke.

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Acknowledgments

This work was supported by Medical Research Council, grant G09000865 (NG), British Heart Foundation (BHF) Intermediate Basic Science Research Fellowship (FS/09/030/27812) and the Centre of Excellence in Medical Engineering funded by the Wellcome Trust and EPSRC under Grant No. WT 088641/Z/09/Z (JA). This research was also supported by the National Institute for Health Research (NIHR) Biomedical Research Centre at Guy’s and St Thomas’ NHS Foundation Trust and King’s College London. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health.

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Authors and Affiliations

  1. Division of Imaging Sciences and Biomedical Engineering, St. Thomas’ Hospital, King’s College London, London, UK

    N. R. Gaddum, J. Alastruey & T. Schaeffter

  2. Department of Pediatric Cardiology & Pediatric Intensive Care Medicine, Hannover Medical School, Hannover, Germany

    P. Beerbaum

  3. St Thomas’ Hospital, King’s College London British Heart Foundation Centre, London, UK

    P. Chowienczyk

Authors
  1. N. R. Gaddum
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  2. J. Alastruey
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  3. P. Beerbaum
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  4. P. Chowienczyk
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  5. T. Schaeffter
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Correspondence to N. R. Gaddum.

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Associate Editor Nathalie Virag oversaw the review of this article.

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Gaddum, N.R., Alastruey, J., Beerbaum, P. et al. A Technical Assessment of Pulse Wave Velocity Algorithms Applied to Non-invasive Arterial Waveforms. Ann Biomed Eng 41, 2617–2629 (2013). https://doi.org/10.1007/s10439-013-0854-y

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  • DOI: https://doi.org/10.1007/s10439-013-0854-y

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