Detection of aortic wall inclusions using regional pulse wave propagation and velocity in silico

Abstract

Monitoring of the regional stiffening of the arterial wall may prove important in the diagnosis of various vascular pathologies. The pulse wave velocity (PWV) along the aortic wall has been shown to be dependent on the wall stiffness and has played a fundamental role in a range of diagnostic methods. Conventional clinical methods entail global examination of the pulse traveling between two remote sites, e.g. femoral and carotid arteries, to provide an average PWV estimate. However, the majority of vascular diseases entail regional vascular changes and therefore may not be detected by a global PWV estimate. In this paper, a fluid-structure interaction study of straight-geometry aortas of 350 mm length is described aimed at examining the effects of regional stiffness changes on the PWV. Five homogeneous aortas with increasing wall stiffness as well as two aortas with soft and hard inclusions of 5 mm length were considered. In each case, spatio-temporal maps of the wall motion were used to analyze the regional pulse wave propagation. On the homogeneous aortas, increasing PWVs were found to increase with the wall moduli (R2 = 0.9988), indicating the reliability of the model to accurately represent the wave propagation. On the inhomogeneous aortas, formation of reflected and standing waves was observed at the site of the hard and soft inclusions, respectively. Neither the hard nor the soft inclusion had a significant effect on the velocity of the traveling pulse beyond the inclusion site, which supported the hypothesis that a global measurement of the average PWV could fail to detect small, regional abnormalities.

Keywords

• Aortic pulse wave velocity (PWV)
• Aortic wall stiffness
• Regional stiffening
• Regional softening
• Pulse wave imaging (PWI)