Sofia Poloni, Luca Soliveri, Anna Caroli, Andrea Remuzzi, Michela Bozzetto
{"title":"声音分析揭示血液透析动静脉瘘管血液动力学状况的潜力。","authors":"Sofia Poloni, Luca Soliveri, Anna Caroli, Andrea Remuzzi, Michela Bozzetto","doi":"10.1007/s10439-024-03638-2","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>Arteriovenous fistula (AVF), the preferred vascular access for hemodialysis, is associated with high failure rate. The aim of this study was to investigate the potential of AVF sound auscultation in providing quantitative information on AVF hemodynamic conditions.</p><p><strong>Methods: </strong>This single-center prospective study involved six patients with native radio-cephalic AVFs who underwent multiple follow-up visits. Doppler Ultrasound blood flow volume (BFV) assessment and electronic stethoscope-based sound recordings were performed during each visit, whereas MRIs were acquired 3 days, 3 weeks and 1 year after surgery. Computational fluid dynamic (CFD) simulations were performed on patient-specific MRI-derived geometrical models.</p><p><strong>Results: </strong>Higher values of median peak amplitudes ratios (high-low peak ratio-HLPR) were found to be associated with complex blood flow and velocity streamlines recirculation at systolic peak, and corresponding extended regions of high oscillatory shear index (OSI). On the contrary, lower values of HLPR were associated with laminar flow pattern and low values of OSI. Significant differences were observed in HLPR between subgroups with extended or limited areas with OSI > 0.1 (0.67 vs 0.31, respectively). Significant relationships were found between AVF sound intensity and brachial BFV (slope = 0.103, p < 0.01) as well as between longitudinal changes in brachial BFV and HLPR (slope = - 0.001, p < 0.01).</p><p><strong>Conclusion: </strong>Our results show that AVF sound can be exploited to extract fundamental information on AVF hemodynamic conditions, providing indication of the presence of complex hemodynamic and adequate BFV to perform hemodialysis. Sound analysis has therefore the potential to improve clinical AVF surveillance and to ameliorate outcome.</p>","PeriodicalId":7986,"journal":{"name":"Annals of Biomedical Engineering","volume":null,"pages":null},"PeriodicalIF":3.0000,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The Potential of Sound Analysis to Reveal Hemodynamic Conditions of Arteriovenous Fistulae for Hemodialysis.\",\"authors\":\"Sofia Poloni, Luca Soliveri, Anna Caroli, Andrea Remuzzi, Michela Bozzetto\",\"doi\":\"10.1007/s10439-024-03638-2\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>Arteriovenous fistula (AVF), the preferred vascular access for hemodialysis, is associated with high failure rate. The aim of this study was to investigate the potential of AVF sound auscultation in providing quantitative information on AVF hemodynamic conditions.</p><p><strong>Methods: </strong>This single-center prospective study involved six patients with native radio-cephalic AVFs who underwent multiple follow-up visits. Doppler Ultrasound blood flow volume (BFV) assessment and electronic stethoscope-based sound recordings were performed during each visit, whereas MRIs were acquired 3 days, 3 weeks and 1 year after surgery. Computational fluid dynamic (CFD) simulations were performed on patient-specific MRI-derived geometrical models.</p><p><strong>Results: </strong>Higher values of median peak amplitudes ratios (high-low peak ratio-HLPR) were found to be associated with complex blood flow and velocity streamlines recirculation at systolic peak, and corresponding extended regions of high oscillatory shear index (OSI). On the contrary, lower values of HLPR were associated with laminar flow pattern and low values of OSI. Significant differences were observed in HLPR between subgroups with extended or limited areas with OSI > 0.1 (0.67 vs 0.31, respectively). Significant relationships were found between AVF sound intensity and brachial BFV (slope = 0.103, p < 0.01) as well as between longitudinal changes in brachial BFV and HLPR (slope = - 0.001, p < 0.01).</p><p><strong>Conclusion: </strong>Our results show that AVF sound can be exploited to extract fundamental information on AVF hemodynamic conditions, providing indication of the presence of complex hemodynamic and adequate BFV to perform hemodialysis. Sound analysis has therefore the potential to improve clinical AVF surveillance and to ameliorate outcome.</p>\",\"PeriodicalId\":7986,\"journal\":{\"name\":\"Annals of Biomedical Engineering\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":3.0000,\"publicationDate\":\"2024-11-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Annals of Biomedical Engineering\",\"FirstCategoryId\":\"5\",\"ListUrlMain\":\"https://doi.org/10.1007/s10439-024-03638-2\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"ENGINEERING, BIOMEDICAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Annals of Biomedical Engineering","FirstCategoryId":"5","ListUrlMain":"https://doi.org/10.1007/s10439-024-03638-2","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ENGINEERING, BIOMEDICAL","Score":null,"Total":0}
The Potential of Sound Analysis to Reveal Hemodynamic Conditions of Arteriovenous Fistulae for Hemodialysis.
Purpose: Arteriovenous fistula (AVF), the preferred vascular access for hemodialysis, is associated with high failure rate. The aim of this study was to investigate the potential of AVF sound auscultation in providing quantitative information on AVF hemodynamic conditions.
Methods: This single-center prospective study involved six patients with native radio-cephalic AVFs who underwent multiple follow-up visits. Doppler Ultrasound blood flow volume (BFV) assessment and electronic stethoscope-based sound recordings were performed during each visit, whereas MRIs were acquired 3 days, 3 weeks and 1 year after surgery. Computational fluid dynamic (CFD) simulations were performed on patient-specific MRI-derived geometrical models.
Results: Higher values of median peak amplitudes ratios (high-low peak ratio-HLPR) were found to be associated with complex blood flow and velocity streamlines recirculation at systolic peak, and corresponding extended regions of high oscillatory shear index (OSI). On the contrary, lower values of HLPR were associated with laminar flow pattern and low values of OSI. Significant differences were observed in HLPR between subgroups with extended or limited areas with OSI > 0.1 (0.67 vs 0.31, respectively). Significant relationships were found between AVF sound intensity and brachial BFV (slope = 0.103, p < 0.01) as well as between longitudinal changes in brachial BFV and HLPR (slope = - 0.001, p < 0.01).
Conclusion: Our results show that AVF sound can be exploited to extract fundamental information on AVF hemodynamic conditions, providing indication of the presence of complex hemodynamic and adequate BFV to perform hemodialysis. Sound analysis has therefore the potential to improve clinical AVF surveillance and to ameliorate outcome.
期刊介绍:
Annals of Biomedical Engineering is an official journal of the Biomedical Engineering Society, publishing original articles in the major fields of bioengineering and biomedical engineering. The Annals is an interdisciplinary and international journal with the aim to highlight integrated approaches to the solutions of biological and biomedical problems.