Die Dynamik des arteriellen systems

Wezler, K.; Böger, Andreas

doi:10.1007/bf02322413

Cited by 413 publications

(21 citation statements)

References 4 publications

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“…Pd and mean pressures (Pm) were set equal at brachial and central aorta (30,34,39): Pd brachial pressure (Pdb) ϭ Pd aortic pressure (Pda) and brachial Pm (Pmb) ϭ aortic Pm (Pma). We used the following form factors (FFs) [the ratio of (Pm Ϫ Pd)/pulse pressure (PP)] to derive mean brachial artery and central aortic pressure, FF ϭ 0.33 (11,57) and FF ϭ 0.40 (4,6,49), respectively.…”

Section: Methodsmentioning

confidence: 99%

Aortic function quantified: the heart's essential cushion

Saouti

Marcus

Noordegraaf

et al. 2012

Journal of Applied Physiology

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Arterial compliance is mainly determined by the elasticity of proximal large-conduit arteries of which the aorta is the largest contributor. Compliance forms an important part of the cardiac load and plays a role in organ (especially coronary) perfusion. To follow local changes in aortic compliance, as in aging, noninvasive determination of compliance distribution would be of great value. Our goal is to determine regional aortic compliance noninvasively in the human. In seven healthy individuals at six locations, aortic blood flow and systolic/diastolic area (ΔA) was measured with MRI. Simultaneously brachial pulse pressure (ΔP) was measured with standard cuff. With a transfer function we derived ΔP at the same aortic locations as the MRI measurements. Regional aortic compliance was calculated with two approaches, the pulse pressure method, and local area compliance (ΔA/ΔP) times segment length, called area compliance method. For comparison, pulse wave velocity (PWV) from local flows at two locations was determined, and compliance was derived from PWV. Both approaches show that compliance is largest in the proximal aorta and decreases toward the distal aorta. Similar results were found with PWV-derived compliance. Of total arterial compliance, ascending to distal arch (segments 1-3) contributes 40% (of which 15% is in head and arms), descending aorta (segments 4 and 5) 25%, and "hip, pelvic and leg arteries" 20%. Pulse pressure method includes compliance of side branches and is therefore larger than the area compliance method. Regional aortic compliance can be obtained noninvasively. Therefore, this technique allows following changes in local compliance with age and cardiovascular diseases.

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Section: Methodsmentioning

confidence: 99%

Aortic function quantified: the heart's essential cushion

Saouti

Marcus

Noordegraaf

et al. 2012

Journal of Applied Physiology

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“…where BPd = diastolic and BPs = systolic blood pressure (mmHg) [32]. 2m is derived by transformation of the mathematical description of aortic cross-sectional distensibility:…”

Section: Hemodynamicsmentioning

confidence: 99%

“…Because the arterial mean pressure according to Wezler and B6ger [32] (BPm = y) and the term Lehmann et al [10,34,35] use for pressure correction [delta p/ln(ps/pd) = x] contain the same information and are nearly identical (y = 1.183 + 0.982 x x; r = 0.9998, for ps = 60 -240 and pd = 30 -210 mmHg), 2m can be found to be numerically twice the value of Cp.…”

Section: Hemodynamicsmentioning

confidence: 99%

“…Other equivalents, such as aortic input impedance and effective arterial elastance, reflect the pulsatile components of left ventricular afterload [41][42][43]. Aortic stiffness can be assessed most easily by measurement of pulse wave velocity (Cw), with a high Cw indicating increased stiffness and vice versa [14,18,[30][31][32][33][34][35][36][44][45][46][47][48][49][50]. The pulse wave velocity mirrors the average stiffness of the aortic pathway and can provide more information than techniques measuring the aortic diameter at only one defined site [51].…”

Section: Assessment Of Aortic Elastic Propertiesmentioning

confidence: 99%

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Influence of antihypertensive therapy with cilazapril and hydrochlorothiazide on the stiffness of the aorta

Breithaupt-Grögler¹,

Leschinger²,

Gg³

et al. 1996

Cardiovasc Drug Ther

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The purpose of this study was to examine the effects of the angiotensin-converting enzyme (ACE) inhibitor cilazapril on the elastic properties of the aorta. A standard diuretic antihypertensive drug, hydrochlorothiazide, served for comparisons. Increased aortic stiffness leads to a reduction of the buffering windkessel function and is a major component in the pathophysiology of systolic hypertension, inducing an increase in left ventricular afterload and arterial pulsatile stress as well as a decrease in the subendocardial blood supply. Stiffness of arteries increases with age and blood pressure, and depends on the functional elastic structures of the aortic wall. ACE inhibitors have been shown to directly influence elastic properties of peripheral arteries. Seventeen patients with mild to moderate essential hypertension (age 45-67 years) were treated for 3 months double-blind randomized with either cilazapril (C) 5 mg daily (n = 9) or hydrochlorothiazide (HCTZ) 25 mg daily (n = 8). Aortic elastic properties were noninvasively assessed by measurement of pulse wave velocity along the aorta at rest and during isometric handgrip stress. Accelerated pulse wave velocity indicates elevated arterial stiffness and vice versa. A pressure standardized index of aortic cross-sectional distensibility (2 m) was calculated from arterial mean pressure and pulse wave velocity. Compared with pretreatment values, both therapies significantly reduced blood pressure and pulse wave velocity at rest (C: 9.4 +/- 0.9 vs. 7.7 +/- 0.7 m/sec; HcTZ: 8.9 +/- 0.3 vs. 7.8 +/- 0.4 m/sec; means +/- SEM p < 0.05). During isometric stress only C showed a significant decrease in pulse wave velocity (C: 11.3 +/- 0.8 vs. 9.1 +/- 0.8 m/sec; HCTZ: 9.9 +/- 0.5 vs. 9.0 +/- 0.5 m/sec; means +/- SEM p < 0.05). The index 2m at rest and during handgrip increased significantly (p < 0.05) after C but not after HCTZ. With cilazapril we obtained steeper slopes for the treatment-induced reductions in blood pressure and pulse wave velocity for both rest and handgrip stress values. Correlation of the data at rest and during stress revealed a direct relationship between blood pressure and pulse wave velocity. HCTZ linearly extended the relation observed before treatment toward lower values of blood pressure and corresponding pulse wave velocity without changing the relation per se. Cilazapril, in contrast, moved the relation between these variables and decelerated the pulse wave velocities to a greater extent than would have been expected from the corresponding blood pressure reduction (delta approximately 1 m/sec). These results in patients with mild to moderate essential hypertension support the idea that ACE inhibitors, in addition to reducing blood pressure, may exert an additional hemodynamic effect in improving the elastic properties of the aorta.

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“…Die unblutige Meßmethode zur Analyse der Herz-und Kreislaufdynamik nach Broemser und Ranke bzw. nach Wezler und Böger (3,4,7,8,16,18,28) ist in den letzten Jahren durch anglo-amerikanische Veröffentlichungen (26,27) als Systolic Time Intervals wieder ins Blickfeld der kardialen Diagnostik getreten. In der vorliegenden Studie werden zunächst die Normalwerte der systolischen Zeitintervalle (nachfolgend als STI bezeichnet) bei Kindern aufgelistet.…”

Section: Introductionunclassified

Die Bestimmung der systolischen Zeitintervalle bei herzgesunden und mit Adriamycin behandelten Kindern

En¹,

Hoffmann²

1984

Klin Padiatr

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The systolic time intervals have been measured in 212 normal children, aged 3 to 16 years, and in 30 children with malignant tumours, who were treated with Adriamycin. The normal values of STI in children were calculated and evaluated. Nomogramms for Left Ventricular Ejection Time (LVET) and Pre-ejection Period (PEP) are presented to permit rapid estimation of predicted normal values in children. The evaluation of 5 consecutive heart cycles is enough for measuring STI. Statistically no significant differences were found not only between STI in girls and boys but also between STI-values measuring in the morning, at noon or in the afternoon. Adriamycin-cardiomyopathy can be detected early and reliable through the estimation of the STI.

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Die Dynamik des arteriellen systems

Cited by 413 publications

References 4 publications

Aortic function quantified: the heart's essential cushion

Aortic function quantified: the heart's essential cushion

Influence of antihypertensive therapy with cilazapril and hydrochlorothiazide on the stiffness of the aorta

Die Bestimmung der systolischen Zeitintervalle bei herzgesunden und mit Adriamycin behandelten Kindern

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