Computational assessment of hemodynamics-based diagnostic tools using a database of virtual subjects: Application to three case studies

摘要

Many physiological indexes and algorithms based on pulse wave analysis have been suggested in order to better assess cardiovascular function. Because these tools are often computed from in-vivo hemodynamic measurements, their validation is time-consuming, challenging, and biased by measurement errors. Recently, a new methodology has been suggested to assess theoretically these computed tools: a database of virtual subjects generated using numerical 1D-0D modeling of arterial hemodynamics. The generated set of simulations encloses a wide selection of healthy cases that could be encountered in a clinical study. We apply this new methodology to three different case studies that demonstrate the potential of our new tool, and illustrate each of them with a clinically relevant example: (i) we assess the accuracy of indexes estimating pulse wave velocity, (ii) we validate and refine an algorithm that computes central blood pressure, (iii) we investigate theoretical mechanisms behind the augmentation index. Our database of virtual subjects is a new tool to assist the clinician: it provides insight into the physical mechanisms that explains the correlations observed in clinical practice.