On the similarity between aortic and carotid pressure diastolic decay: a mathematical modelling study

Abstract

Aortic diastolic pressure decay (DPD) has been shown to have considerable pathophysiological relevance in the assessment of vascular health, as it is significantly affected by arterial stiffening. Nonetheless, the aortic pressure waveform is rarely available and hence the utility of the aortic DPD is limited. On the other hand, carotid blood pressure is often used as a surrogate of central (aortic) blood pressure in cardiovascular monitoring. Although the two waveforms are inherently different, it is unknown whether the aortic DPD shares a common pattern with the carotid DPD. In this study, we compared the DPD time constant of the aorta (aortic RC) and the DPD time constant of the carotid artery (carotid RC) using an in-silico-generated healthy population from a previously validated one-dimensional numerical model of the arterial tree. Our results demonstrated that there is near-absolute agreement between the aortic RC and the carotid RC. In particular, a correlation of ~ 1 was reported for a distribution of aortic/carotid RC values equal to 1.76 ± 0.94 s/1.74 ± 0.87 s. To the best of our knowledge, this is the first study to compare the DPD of the aortic and the carotid pressure waveform. The findings indicate a strong correlation between carotid DPD and aortic DPD, supported by the examination of curve shape and the diastolic decay time constant across a wide range of simulated cardiovascular conditions. Additional investigation is required to validate these results in human subjects and assess their applicability in vivo.

Novel theory and potential applications of central diastolic pressure decay time constant

“…However, carotid blood pressure is considered as a well-established surrogate of central blood pressure, and it is frequently used as a replacement to the aortic blood pressure measurement. Adding to this, recent evidence demonstrated a near-absolute agreement between the aortic and the carotid values in an in silico population of virtual subjects 28 , contributing additional support to the similarities observed in the pressure waves between the aorta and the carotid.…”

Wave Separation Analysis to Assess Cardiovascular Alterations Induced by Sepsis

“…In our protocol ABP and ABF were collected at the carotid arterial site, since this has been used in the original publication [25] aortic signals were therefore not available for this study. Nevertheless, carotid artery pressure is often used as a surrogate for central artery or aortic pressure because of the close proximity of these arterial sites [37], [38]. In addition, the carotid artery is the main vessel responsible for oxygen delivery to the brain tissue, and pathological changes of the carotid artery and consequent alterations in pulse wave propagation and reflection can have an impact on the brain microcirculation due to an altered pulsatility dampening [39], [40].…”