Artificial intelligence-based assessment of central aortic haemodynamics using non-invasive pulse wave analysis in constrictive pericarditis

Q: What clinical problem does AI-PWA aim to improve in constrictive pericarditis?

It targets impaired haemodynamic assessment in constrictive pericarditis, where symptoms and peripheral blood pressure patterns can resemble other heart failure causes. The study evaluates whether AI-based pulse wave analysis better characterizes central aortic dynamics and arterial stiffness.

Q: How was the study designed and who participated?

A prospective case-control design enrolled 12 adult patients with constrictive pericarditis and 12 age- and sex-matched healthy controls. Central aortic blood pressure and peripheral blood pressure were measured using VascAssist2.

Q: What were the key findings comparing CP patients with controls?

CP patients had lower mean central aortic blood pressure than systolic peripheral blood pressure and showed higher pulse wave velocity and augmentation index values, indicating increased arterial stiffness and wave reflection. Cardiac performance was also impaired, with reduced stroke volume and dP/dtmax and a higher heart failure index.

Sep 29, 2026

Uploaded by Grenda

Constrictive pericarditis is a rare but consequential pericardial disorder that impairs ventricular filling and produces heart failure symptoms, often after cardiac surgery. Its presentation can mimic other causes of heart failure, complicating diagnosis. This prospective case-control study assesses the clinical utility of AI-based non-invasive pulse wave analysis for central aortic blood pressure, arterial stiffness and cardiac function in constrictive pericarditis. Twelve patients and twelve matched controls were compared using VascAssist2-derived haemodynamic metrics.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages10

Reading Time25 min

AccessFree to download

Abstract

Background

Objectives

Methods

Results

Conclusion

Introduction

Clinical significance of constrictive pericarditis

Diagnostic challenges after cardiac surgery

Historical context

Open access Cardiac surgery Artificial intelligence-based assessment of central aortic haemodynamics using non-invasive pulse wave analysis in constrictive pericarditis Mathieu N Suleiman ,1 Oliver Dewald,1 Helena Dreher,2 Ann-Sophie Kaemmerer-Suleiman,1 Frank Klawonn,3 Martin Middeke,4 Robert Pittrow,1 Frank Harig,1 Fritz Mellert1 ► Additional supplemental material is published online only. To view, please visit the journal online ([https://doi.org/10.1136/](https://doi.org/10.1136/)[ ](https://doi.org/10.1136/)[openhrt-2025-003628](openhrt-2025-003628)) . To cite: Suleiman MN, Dewald O, Dreher H, et al. Artificial intelligence-based assessment of central aortic haemodynamics using noninvasive pulse wave analysis in constrictive pericarditis. Open Heart 2025;12:e003628 . doi:10.1136/ openhrt-2025-003628 Received 10 August 2025 Accepted 18 November 2025 © Author(s) (or their employer(s)) 2025. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ Group. 1Department of Cardiac Surgery, University Hospital Erlangen , Erlangen, Bayern, Germany 2International Center for Adults with Congenital Heart Disease, German Heart Centre Munich, Munich, Germany 3Biostatistics, Helmholtz Center for Infection Research, Braunschweig, Germany 4Hypertension Center Munich, München, Germany Correspondence to Dr Mathieu N Suleiman; mathieu.suleiman@uk[erlangen.de](erlangen.de) ABSTRACT Background Constrictive pericarditis (CP) is a rare but significant pericardial disease resulting in impaired ventricular filling and heart failure symptoms, often following cardiac surgery. Its clinical presentation complicates diagnosis, mimicking other causes of heart failure. Recent technological advances, including artificial intelligence (AI)-based non-invasive pulse wave analysis (AI-PWA), have the potential for improved haemodynamic assessment and clinical decision-making. Objectives This study evaluates the clinical utility of AIPWA in assessing central aortic blood pressure (CABP), arterial stiffness and cardiac function in CP. Methods This prospective case-control study enrolled 12 adult CP patients and 12 age-and sex-matched healthy controls. CABP and peripheral blood pressure (PBP) were measured using the VascAssist2 . Haemodynamic parameters, including pulse wave velocity (PWV), augmentation index@75 (AIx@75), cardiac index, stroke volume and dP/dtmax, were assessed and compared between groups. Results CP patients showed significantly lower mean CABP than systolic PBP (101 .8±23 .4 mm Hg vs 112.3±22 .9 mm Hg) . PWV showed elevated values (>9 m/s) in nnn (42%) of cases, indicating increased arterial stiffness (8 .88±1 .94 m/s) . AIx@75 was higher in CP patients (22 .55±8 .36%) compared with controls (16 .38±6 .53%), reflecting increased wave reflection, increased systemic vascular resistance or enhanced aortic compliance. Cardiac performance was notably impaired in the CP group, with reduced stroke volume (64 .8±18 .8 mL vs 94.9±25.0 mL, p=0.003) and dP/dtmax (724.9±228.2 mm Hg/s vs 1055.3±203 .2 mmHg/s, p=0 .0011), indicating impaired ventricular function. The heart failure index was significantly higher in CP patients (31.8±18.3% vs . 6.4±6 .5%, p<0 .001), indicating substantial functional compromise. Conclusion AI-PWA provides clinically relevant insights into central haemodynamics and arterial stiffness in CP patients. This non-invasive approach may enhance diagnosis and management of CP and should be considered for integration into routine cardiologic evaluation protocols. | WHAT IS ALREADY KNOWN ON THIS TOPIC | | --- | | ⇒ Constrictive pericarditis (CP) is a rare and often underdiagnosed condition that leads to significant cardiac dysfunction due to a stiffened pericardium. Diagnosing CP can be difficult, especially after cardiac surgery, as its symptoms and haemodynamic patterns resemble those of other heart failure syndromes. Peripheral blood pressure (PBP)

FAQs

What clinical problem does AI-PWA aim to improve in constrictive pericarditis?

It targets impaired haemodynamic assessment in constrictive pericarditis, where symptoms and peripheral blood pressure patterns can resemble other heart failure causes. The study evaluates whether AI-based pulse wave analysis better characterizes central aortic dynamics and arterial stiffness.

How was the study designed and who participated?

A prospective case-control design enrolled 12 adult patients with constrictive pericarditis and 12 age- and sex-matched healthy controls. Central aortic blood pressure and peripheral blood pressure were measured using VascAssist2.

What were the key findings comparing CP patients with controls?

CP patients had lower mean central aortic blood pressure than systolic peripheral blood pressure and showed higher pulse wave velocity and augmentation index values, indicating increased arterial stiffness and wave reflection. Cardiac performance was also impaired, with reduced stroke volume and dP/dtmax and a higher heart failure index.

Sep 29, 2026

Uploaded by Grenda