-132-the Second Component of Left Ventricular Systolic Pressure

Estimation of central aortic systolic pressure using late systolic inflection of radial artery pulse and its application to vasodilator therapy

“…They defined augmentation index as the difference between late SBP (SBP2) and early SBP (SBP1) normalized by the pulse pressure (PP): (SBP2 À SBP1)/PP, which was the same as the 'aortic reflection wave ratio' introduced by us in earlier studies [2]. Kelly and colleagues showed an age-related increase in augmentation index at the radial and carotid arteries and at the ascending aorta based on the study of Murgo et al [3] and on our previous studies [2,[4][5][6]. We reported that augmentation index could be a surrogate marker for cardiac afterload [7].…”

“…It is not evident that the ejection wave and the reflection wave can be correctly identified by detection of the point of inflection. Kelly et al [1] cited two studies, one by Murgo et al [3] and the other by us [4], to calculate the ascending aortic augmentation index. Furthermore, they used the BP of an early systolic inflection point described in two separate studies and calculated the augmentation index.…”

“…Furthermore, they used the BP of an early systolic inflection point described in two separate studies and calculated the augmentation index. The point of inflection had been determined solely by means of visual inspection of the wave shape observed at that time [3,4]; however, Kelly et al [1] claimed that objective recognition of the inflection point was necessary. Moreover, they reported that the point of inflection could be recognized by using the second zero crossing from above to below zero of the fourth derivative of the original pressure wave.…”

“…As an index of wave reflection [4,11], augmentation index was defined as the ratio of the height (P2/P1) of the late systolic shoulder/peak (P2) to that of the early systolic peak/ shoulder (P1). The maximal systolic BP (rSBP) and DBP (rDBP) in the radial artery were calibrated with the brachial SBP and brachial DBP, respectively.…”

Noninvasive Studies of Central Aortic Pressure

“…Pressure on the carotid artery can stimulate baroreceptors and so cause cardiac slowing, and dislodgement of plaque is a largely theoretic but worrying possibility [1••]. Though some researchers depend on the carotid pulse as a surrogate of the aortic, detailed studies have shown large differences between waveforms at the two sites [22][23][24].…”