A Study of the Central and Peripheral Arterial Pressure Pulse in Man

Abstract

This communication describes and discusses the results obtained in studying central and )eripheral arterial pressure pulses in man by means of retrograde aortic catheterization. The pressure pulse transformation and pulse transmission in the aorticobrachial system are presented and compared with comparable tracings reported in the dog. Several normal subjects and patients with hypertension, aortic regurgitation and coarctation of the aorta were studied. The genesis of the central pulse contour in aortic regurgitation is reconsidered. The changes in central pulse pressure, produced by the Valsalva-like maneuver, and ventricular premature systoles have been investigated, especially in their relationship to cycle length, end-diastolic volume and peripheral resistance. The technic of obtaining pulse pressure recordings by retrograde aortic catheterization is recommended for determining the location, size and dynamic significance of coarctation of the aorta. As an additional study, aortic densograms and border electrokymograms from the aortic arch and left ventricular border were correlated with simultaneously recorded central aortic pressure tracings.C ATHETERIZATION of the human aorta has been used recently for diagnostic purposes in retrograde angiocardiography." 2 This experience prompted the study of cardiovascular hemodynamics by means of retrograde catheterization of the human aorta, a field which has been little explored. This report deals with some preliminary observations on the contour, transmission rate and transformation of the central aortic pressure pulse. As part of this investigation the central pressure pulse was correlated with the simultaneously recorded electrokymogram of the aorta. METHODS AND PROCEDURESimultaneous aortic catheterization and electrokymography were performed in patients for whom the information so gained was thought to be diag-

Pulsatile flow and pressure in human systemic arteries. Studies in man and in a multibranched model of the human systemic arterial tree.

“…This explanation has not been as obvious in man, because man often does not show the same evidence of wave reflection-a prominent diastolic wave (Porje, 1946;Salans et al, 1951;Kroeker and Wood, 1956;O'Rourke et al, 1968) as is regularly seen in dogs, rabbits, sheep, and other experimental animals (Hamilton and Dow, 1939;O'Rourke, 1967;McDonald, 1974), except the guinea pig (Avolio et al, 1976). Children regularly show the same patterns as these animals, but as age advances, the diastolic wave tends to disappear (O'Rourke et al, 1968).…”

“…Children regularly show the same patterns as these animals, but as age advances, the diastolic wave tends to disappear (O'Rourke et al, 1968). In the elderly, in patients with hypertension and arterioscelerosis, the pressure wave is similar in all arteries with a late systolic peak, and with pressure falling exponentially from this peak, interrupted only by the incisura which represents aortic valve closure (Salans et al, 1951;Freis et al, 1966;O'Rourke et al, 1968;O'Rourke, 1970b).…”

Arterial pressure

“…Systolic and diastolic BP are determined by the shape of the BP waveform, which is itself influenced by the interaction between left ventricular ejection and the biomechanical properties of the arterial system. Pulse pressure increases as it travels from the aorta to peripheral locations such as the brachial artery [2], and the difference between aortic and brachial systolic BP (bSBP) can be substantial [3]. In adults, peripheral systolic BP exceeds aortic pressure by approximately 10 mmHg; however, this difference can be much greater especially in younger individuals and with increased heart rate.…”

Strain imaging of internal deformation

“…Though the smoothness of this plot is limited by the frame rate at which echo data were collected, the plot clearly depicts the essential characteristics of brachial arterial pressure profile seen in Fig. 8b (from Remington and Wood 1956;Salans et al 1951). Comparing these curves, we observe that there is a close relationship between the variations in cardiac pressure and those from the resultant strain.…”