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American Physiological Society, American Journal of Physiology - Heart and Circulatory Physiology, 2023

DOI: 10.1152/ajpheart.00454.2023

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Noninvasive hemodynamic indices of vascular aging: an in silico assessment

Journal article published in 2023 by Jingyuan Hong ORCID, Manasi Nandi, Peter H. Charlton ORCID, Jordi Alastruey ORCID
This paper was not found in any repository, but could be made available legally by the author.
This paper was not found in any repository, but could be made available legally by the author.

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Abstract

Vascular ageing (VA) involves structural and functional changes in blood vessels that contribute to cardiovascular disease. Several non-invasive pulse wave (PW) indices have been proposed to assess the arterial stiffness component of VA in the clinic and daily life. This study investigated 19 of these indices, identified in recent review articles on VA, by using a database comprising 3,837 virtual healthy subjects aged 25 to 75 years, each with unique PW signals simulated under various levels of artificial noise to mimic real measurement errors. For each subject, VA indices were calculated from filtered PW signals and compared with the precise theoretical value of aortic Young's modulus (E_Ao). In silico PW indices showed age-related changes that align with in vivo population studies. The cardio-ankle vascular index (CAVI) and all pulse wave velocity (PWV) indices showed strong linear correlations with (Pearson's r_p>0.95). Carotid distensibility showed a strong negative nonlinear correlation (Spearman's r_s<-0.99). CAVI and distensibility exhibited greater resilience to noise compared to PWV indices. Blood-pressure-related indices and photoplethysmography (PPG)-based indices showed weaker correlations with (r_p and r_s<0.89, r_p and r_s<0.84, respectively). Overall, blood-pressure-related indices were confounded by more cardiovascular properties (heart rate, stroke volume, duration of systole, large artery diameter, and/or peripheral vascular resistance) compared to other studied indices, and (PPG)-based indices were most affected by noise. In conclusion, carotid-femoral PWV, CAVI and carotid distensibility emerged as the superior clinical VA indicators, with a strong E_Ao correlation and noise resilience. PPG-based indices showed potential for daily VA monitoring under minimised noise disturbances.