Assessment of cardiac function by pulse wave analysis. A computational study

Abstract The development of methodologies that provide a comprehensive assessment of cardiac function from pulse wave analysis in the systemic circulation could avoid current practice using expensive, invasive and operator-dependent measurement techniques. This work addressed this topic computationally. A cardiovascular model, constituted of a lumped-parameter model of the left part of the heart coupled to a one-dimensional model of the arterial network, was validated using reference pulse waveforms in turn verified by comparison with in vivo measurements. The validation was specifically designed to verify the performance of the model in returning physiological pulse waves for assigned cardiac properties. Successively, a sensitivity analysis was performed to assess the effects of variations in cardiac parameters on central and peripheral pulse waves. Results show that left ventricle contractility, stroke volume, cardiac cycle duration and heart valves impairment are determinants of central waveforms morphology, pulse pressure and its amplification. Contractility of the left atrium has negligible effects on vascular pulse waves. Results also suggest that it may be possible to infer left ventricular dysfunction by analysing the timing of the dicrotic notch. This study suggests which cardiac properties can be extracted from central and peripheral pulse waves to assess cardiac function.