Assessing the Accuracy of Non-Invasive Measuring Methods of Pulse Wave Velocity: An Analysis Based on Fluid-Structure Interaction Simulations in the Carotid Artery

Pulse wave velocity (PWV) is the propagation speed of pressure and flow waves in the arterial system induced by the contracting left ventricle. PWV is a measure of arterial stiffness, and has been shown to predict cardiovascular events. In a clinical setting, PWV is usually associated with carotid-femoral PWV, reflecting the propagation speed over the aorta. It is, however, also possible to assess local PWV at a given measuring location, which reflects the stiffness of the artery under investigation at that particular location. When locally assessing PWV, single-location techniques are commonly used, which rely on the fact that in uniform elastic tubes, the relationship between a change in pressure (dP) and velocity (dU) is constant in the absence of wave reflections. As such, when plotting the pressure P as a function of the velocity U in an artery, a PU-loop is obtained, where reflection-free instants emerge as a straight line (typically during early systole), with a slope given by ρPWV (ρ = blood density). The original method relied on pressure and velocity data (PU-method), but alternative methods have been introduced based on cross-sectional area (A) and flow (Q) (QA-method), or diameter (D) and velocity (U) (ln(D)U-method).