Estimation of local pulse wave velocity using arterial diameter waveforms: Experimental validation in sheep

Increased arterial stiffness is associated with an increased risk of cardiovascular events. Estimation of arterial stiffness using local pulse wave velocity (PWV) promises to be very useful for noninvasive diagnosis of arteriosclerosis. In this work we estimated in an instrumented sheep, the local aortic pulse wave velocity using two sonomicrometry diameter sensors (separated 7.5 cm) according to the transit time method (PWVTT) with a sampling rate of 4 KHz. We simultaneously measured aortic pressure in order to determine from pressure-diameter loops (PWVPDLoop), the true local aortic pulse wave velocity. A pneumatic cuff occluder was implanted in the aorta in order to compare both methods under a wide range of pressure levels. Mean pressure values ranged from 47 to 101 mmHg and mean proximal diameter values from 12.5. to 15.2 mm. There were no significant differences between PWVTT and PWVPDLoop values (451±43 vs. 447±48 cm/s, p = ns, paired t-test). Both methods correlated significantly (R = 0.81, p<0.05). The mean difference between both methods was only 4±29 cm/s, whereas the range of the limits of agreement (mean ± 2 standard deviation) was -61 to +53 cm/s, showing no trend. In conclusion, the diameter waveforms transit time method was found to allow an accurate and precise estimation of the local aortic PWV.