1.School of Naval Architecture, Ocean & Civil Engineering, Shanghai Jiao Tong University, Shanghai 200240, China; 2.Department
of Cardiology, Shanghai Sixth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200233, China;
3.Department of Cardiology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai
200011, China; 4.School of Optoelectronic Engineering and Instrumentation Science, Dalian University of Technology, Dalian
Liaoning 116024, China
Abstract：Objective To examine the validity of an upper-arm cuff-based pulse wave device (PASESA AVE-1500) on assessing
central arterial stiffness based on oscillometric waves, and analyze the related influential factors. Methods A computational
model of the cardiovascular system coupled with an upper-arm oscillometric cuff was constructed and applied to simulate the
measurement process of the pulse wave device. With the model, a theoretical study for assessing central arterial stiffness based on
the characteristics of cuff oscillometric wave was performed, followed by a series of numerical experiments aimed to quantify the
sensitivity of the assessment to various cardiovascular parameters. Furthermore, the validity of the pulse wave device was examined
by clinical experiments. Results The computational model-based theoretical study revealed that the ratio of the second valley to
the first peak (|V2|/|P1|) on the time-differentiated cuff wave correlated positively with the stiffness of central arteries. Subsequent
numerical experiments showed that |V2|/|P1| increased with the impairment of cardiac systolic function, but was relatively less
influenced by the total peripheral vascular resistance and the stiffness of the brachial artery. The clinical study demonstrated that the
measured pulse velocity index (AVI) differed significantly between the patient group with cardiovascular diseases (n=68) and the
healthy subject group (n=170) (P<0.0001), which was consistent with the inter-group difference observed for brachial-ankle pulse
wave velocity (baPWV) (P<0.0001). In addition, AVI was found to correlate significantly with both baPWV (r=0.656, P<0.0001) and
age (r=0.525, P<0.0001). Conclusion The mechanical property of central arteries can be obtained by analyzing the oscillometric
wave of an upper-arm cuff, which makes it possible to noninvasively and rapidly assess central arterial stiffness.
