Estimating Central Blood Pressure from MRI data using reduced-order computational models

Artery Research(2018)

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摘要
Purpose: Central Blood Pressure (CBP) is a better cardiovascular risk indicator than brachial pressure [1]. However, gold standard CBP measurements require an invasive catheter. We propose an approach to estimate CBP non-invasively from Magnetic Resonance Imaging (MRI) data coupled with a non-invasive brachial pressure measurement, using reduced-order (0-D/1-D) computational models. Our objectives were: identifying optimum model parameter estimation methods and comparing the performance of 0-D/1-D models for estimating CBP. Methods: Populations of virtual (simulated) healthy subjects were generated based on [2]. Pressure and flow waveforms from these populations were used to develop and test Methods: for estimating model parameters. Two common clinical scenarios were considered: when a brachial pressure waveform is available; and when only systolic and diastolic blood pressures are available. Optimal parameter estimation Methods: were identified for each scenario and used with two 0-D Windkessel models and a 1-D aortic model. Results were compared with invasive CBP in a post-coarctation repair population (n = 10). Results: Model parameters were best estimated by: fitting an exponential to the pressure waveform to estimate compliance and outflow pressure; using the least-squares method to estimate pulse wave velocity from flow data; assuming characteristic impedance was 5% of arterial resistance; and estimating end-systolic time from the second derivative of the pressure waveform. Average pulse and systolic CBP errors were <5 mmHg and <2 mmHg, respectively. Conclusions: We have demonstrated the feasibility of estimating CBP from MRI and brachial pressure. Different reduced-order models provided similar performance, although the 1-D model reproduced pressure waveform morphology more accurately.
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