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Biomedical subjects

David S Berger

Publications and source records attributed to David S Berger.

2 recordsLinked to original sources

Resolving the hemodynamic inverse problem.

The "hemodynamic inverse problem" is the determination of arterial system properties from pressures and flows measured at the entrance of an arterial system. Conventionally, investigators fit reduced arterial system models to data, and the resulting model parameters represent putative arterial properties. However, no unique solution to the inverse problem exists-an infinite number of arterial system topologies result in the same input impedance (Zin) and, therefore, the same pressure and flow. Nevertheless, there are exceptions to this theoretical limitation; total peripheral resistance (Rtot), total arterial compliance (Ctot), and characteristic impedance (ZO) can be uniquely determined from input pressure and flow. Zin is determined completely by Ctot and Rtot at low frequencies, Zo at high frequencies, and arterial topology and reflection effects at intermediate frequencies. We present a novel method to determine the relative contribution of Zo, Ctot, Rtot and arterial topology/reflection to Zin without assuming a particular reduced model. This method is tested with a large-scale distributed model of the arterial system, and is applied to illustrative cases of measured pressure and flow. This work, thus, lays the theoretical foundation for determining the arterial properties responsible for increased pulse pressure with age and various arterial system pathologies.

Animals↗

Arterial pulse wave reflection as feedback.

Traditionally, input impedance (Z(in)) has been used to characterize the global dynamic properties of an arterial system independent of properties of the heart. Defined as the relationship of pressure and flow at the entrance of an arterial system, it describes the ability of an arterial system to dynamically impede blood flow. Recently, a new description has been developed that also characterizes the arterial system independent of properties of the heart. Apparent arterial compliance (C(app)) is defined as the dynamic relationship of input pressure and volume stored in an arterial system, and describes the ability of the arterial system to dynamically store blood. Both Z(in) and C(app) are influenced by pulse wave propagation and reflection. However, the functional form of Capp lends itself to describing the arterial system in terms of negative feedback. Pulse wave reflection decreases the pulsatile volume stored (gain) at low frequencies, but increases the range of frequencies (bandwidth) in which the pulsatile volume is determined by total arterial compliance. This paper illustrates, by simple analytical formula, large-scale arterial system modeling, and direct analysis of data, how this conceptualization of reflection offers a new means to interpret changes in arterial system dynamics resulting from changes in arterial compliance.

Animals↗