Two Methods to Assess Aortic Compliance Using Blood Pressure and Pulse-Wave Velocity

2020 ◽  
Author(s):  
Noah Manring ◽  
Mouayed Al-Toki
Keyword(s):  
Blood Pressure ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Pulse Wave Velocity ◽  
Wave Velocity ◽  
Pulse Wave ◽  
Rubber Tube ◽  
Aortic Compliance ◽  
Cardiovascular Morbidity And Mortality

Abstract Aortic compliance has been well established as an independent predictor of cardiovascular morbidity and mortality. The current "gold standard" for assessing aortic compliance is to use the carotid-femoral pulse-wave velocity (PWV) as a surrogate; however, PWV alone has been discussed in the literature as being inadequate for assessing compliance, especially for elderly patients and others who have a stiff aorta. In this paper an equation for the aortic compliance is developed using two approaches: 1) lumped-parameter modeling based on blood-pressure data and 2) distributed modeling based on the PWV. In-vitro experiments are conducted using a silicone-rubber tube which simulates the aorta, and an actual aorta harvested from a 1-year old, Holstein heifer. For both the rubber aorta and the Holstein aorta, a comparison is made between the blood-pressure model and the PWV model. In conclusion it is shown that good agreement exists between the two models, suggesting that either model may be used depending upon the available data. Furthermore, due to differences in material properties, it is shown that the compliance of the rubber aorta increases with mean arterial-pressure, while the compliance of the Holstein aorta decreases with mean arterial-pressure. Clinical implications of this research are also discussed.

scholarly journals Arterial stiffness as a risk factor for hypotension during induction of general anesthesia

2021 ◽  
Author(s):  
Ianis Siriopol ◽  
Ioana Grigoras ◽  
Dimitrie Siriopol ◽  
Adi Ciumanghel ◽  
Daniel Rusu ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Mean Arterial Pressure ◽  
Arterial Stiffness ◽  
Arterial Pressure ◽  
Pulse Wave Velocity ◽  
General Anaesthesia ◽  
Wave Velocity ◽  
Pulse Wave ◽  
Systolic Arterial Pressure ◽  
Post Induction

IntroductionHypotension after induction of general anaesthesia is identified as an independent factor in predicting adverse clinical outcomes. Preoperative evaluation of arterial stiffness could identify patients with an impaired vascular function and an altered haemodynamic response to induction of general anaesthesia. The purpose of this study is to investigate the relationship between arterial stiffness and blood pressure variation during induction of general anaesthesia.Material and methodsThis was an observational study that included patients who underwent surgical procedures under general anaesthesia. We used several systolic arterial pressure and mean arterial pressure thresholds for defining hypotension. Both absolute thresholds and thresholds relative to a baseline blood pressure were chosen based on the most frequently used definitions. Patient carotid-femoral pulse wave velocity determination, preoperative preparation, and induction of general anaesthesia were standardized.ResultsOur study included 115 patients. Both univariate and multivariate analysis showed that carotid-femoral pulse wave velocity was significantly associated with post-induction hypotension when defined as a systolic arterial pressure decrease of > 30% or > 40% from baseline or as a mean arterial pressure decrease of > 40% from baseline. Also, carotid-femoral pulse wave velocity was positively associated with duration of post-induction hypotension.ConclusionsPreoperative assessment of arterial stiffness identifies patients at risk of a pronounced decrease in blood pressure during induction of general anaesthesia.

P1674High intensity interval exercise program in heart failure patients seems to benefit cardiac power along with aorto-ventricular mechanical pump capacity and cardiorespiratory indices

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
C Chrysohoou ◽  
A Angelis ◽  
G Titsinakis ◽  
D Tsiachris ◽  
P Aggelopoulos ◽  
...  
Keyword(s):  
Heart Failure ◽  
Blood Pressure ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Pulse Wave Velocity ◽  
Pulse Wave ◽  
Intervention Group ◽  
Control Group ◽  
Interval Exercise ◽  
Cardiac Power

Abstract Background Cardiac power has been suggested as the most power predictor of mortality in heart failure (HF) patients. In those patients aorta elastic properties and compensation is lost, systolic (and pulse) pressure are therefore reduced and associated with a decrease in ejection duration and pump efficiency. Cardiac rehabilitation programs have showed enhancement in cardiac performance and quality of life in HF patients. Aim Aim of this work was to evaluate the effect of high-intensity interval exercise (i.e., 30 sec at 100% of max workload, followed by 30 sec at rest, on a day-by-day 30 minutes working-out schedule for 12 weeks), on cardiac power, diastolic function indices, right ventricle performance and cardiorespiratory parameters among chronic HF patients. Methods 72 consecutive HF patients (NYHA class II-IV, ejection fraction <50%) who completed the study (exercise training group, n=33, 63±9 years, 88% men, and control group, n=39, 56±11 years, 82% men), underwent cardiopulmonary stress test, non-invasive high-fidelity tonometry of the radial artery, pulse wave velocity measurement using a SphygmoCor device, and echocardiography before and after completion of the training program. Cardiac power output (CPO) (W) was calculated as mean arterial pressure × CO/451, where mean arterial pressure = [(systolic blood pressure − diastolic blood pressure)/3] + diastolic blood pressure. Results Both groups reported similar medical characteristics and physical activity status. General mixed effects models revealed that the intervention group increased 6MWT (by 13%, p<0.05); increased cycle ergometry WRpeak (by 25%, p<0.01), showed higher O2max by 31% (p<0.001) and lower VE/VCO2 (p=0.05), whereas patients in the control group showed nosignificant changes in the aforementioned indices. Also, in the intervention group Emv/Vp was decreased by 14% (p=0.06); E to A ratio by 24% (p=0.004) and E to Emv ratio by 8% (p=0.05); while Stv increased by 25% (p=0.01). Most importantly, the intervention group reduced pulse wave velocity by 9% (p=0.05) and increased augmentation index by 26%; and VTI by 4% (p=0.05); Those parameters were not significantly changed on control group (all p>0.05). Conclusion Hight intensity exercise rehabilitation program revealed beneficial effect on left ventricular diastolic indices and right ventricle performance. As, in those patients compensation of the aorta is also lost and the LV cannot generate the extra force necessary to completely overcome the late systolic augmented pressure, the increase in the augmented pressure (AIa) observed in the intervention group reflects the benefit in aorto-ventricular coupling and cardiac power that boosts systolic pressure and restores a positive influence in pressure, like in early stages of HF. Acknowledgement/Funding None

scholarly journals Migraine and Arterial Stiffness in the Brazilian Longitudinal Study of Adult Health: ELSA-Brasil

2020 ◽  
Vol 33 (5) ◽  
pp. 458-464 ◽  
Author(s):  
Patricia Noemi Apelbaum ◽  
Alessandra Carvalho Goulart ◽  
Itamar de Souza Santos ◽  
Paulo Andrade Lotufo ◽  
Cristina Pellegrino Baena ◽  
...  
Keyword(s):  
Longitudinal Study ◽  
Mean Arterial Pressure ◽  
Arterial Stiffness ◽  
Arterial Pressure ◽  
Pulse Wave Velocity ◽  
Wave Velocity ◽  
Sex Education ◽  
Pulse Wave ◽  
International Headache Society ◽  
Adult Health

Abstract Background The mechanisms that underlie the link between migraine and cardiovascular diseases are not clear and arterial stiffness could play a role in that association. We analyzed the association between migraine and vascular stiffness measured by carotid-to-femoral pulse wave velocity (PWV-cf). Methods In a cross-sectional analysis of a well-defined population from the Longitudinal Study of Adult Health (ELSA-Brasil) with complete and validated information about migraine and aura according to the International Headache Society criteria, the association between arterial stiffness measured by PWV-cf was tested with multiple linear regression models [β (95% CI)] comparing migraine without aura (MO) and migraine with aura (MA) to the reference group no-migraine (NM). Subsequent adjustments were made for mean arterial pressure, age, sex, education level, physical activity, alcohol use, diabetes mellitus, smoking, antihypertensive medication, body mass index, waist circumference, triglycerides, and LDL-c level to test the independence of the association between migraine status and pulse wave velocity. Results We studied 4,649 participants, 2,521 women (25.7% MO and 15% MA) and 2,128 men (11% MO and 4.3% MA). In NM, MO, and MA standard PWV-cf were 8.67 (±1.71) 8.11 (±1.31) and 8.01 (±1.47) m/s, respectively. Unadjusted PWV-cf differed between NM, MA, and MO (P &lt; 0.001). After adjustment for mean arterial pressure PWV-cf in NM did not differ anymore from MA (P = 0.525) and MO (P = 0.121), respectively. Fully adjusted models also yielded nonsignificant coefficients β (95% CI) −0.079 (−0.280; 0.122) and −0.162 (−0.391; 0.067) for MO and MA, respectively. Conclusion In this large cohort of middle-aged adults, aortic PWV was not associated with migraine.

Relation Between Blood Pressure Estimated by Pulse Wave Velocity and Directly Measured Arterial Pressure

2012 ◽  
Vol 24 (5) ◽  
pp. 811-819 ◽  
Author(s):  
Tsukasa Inajima ◽  
◽  
Yasushi Imai ◽  
Masaki Shuzo ◽  
Guillaume Lopez ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Intensive Care ◽  
Arterial Pressure ◽  
Pulse Wave Velocity ◽  
Systolic Blood Pressure ◽  
Wave Velocity ◽  
Pressure Measurement ◽  
Pulse Wave ◽  
Blood Pressure Measurement ◽  
Pressure Sensors

Hypertension is the strongest risk factor in cardiac and cerebrovascular diseases among the Japanese. Even daily variations in blood pressure may become a risk, and repeated blood pressure measurement is recommended. Conventional Ambulatory Blood Pressure Monitoring (ABPM), however,may cause discomfort to examinees because they have to have their arms compressed and carry the monitor itself. The number of ABPMmeasurements is limited to about 1 every 15–30 minutes. We therefore attempted, working with medical and engineering teams, to develop a wearable blood pressure sensor that would place less burden on examinees, be less influenced by physical movement, and be usable for continuous blood pressure measurement. We then examined the clinical practicality of the sensor. We modified the existing Moens-Korteweg blood-pressure equation and developed a new systolic blood pressure calculation system that used electrocardiography and ear-lobe pulse waves because the ear lobe would receive little influence from physical movement. We chose three clinical cases from among intensive care unit subjects. We not only estimated their blood pressure using the systemwe developed but also measured arterial pressure directly with an intravascular catheter to see how estimated blood pressure followed actual changes in blood pressure and to evaluate the accuracy of estimated blood pressure. When systolic blood pressure estimated by using the pulse wave velocity method was compared with direct blood pressure measurement, we found that the method captured trends in blood pressure variations correctly. The difference was within ±10 mmHgfor all of the cases. In a comparison using the Bland-Altman method for the three clinical cases, the average difference was –0.4 mmHg, –1.0 mmHg, and –1.7 mmHg and standard deviation was 4.2 mmHg, 4.8 mmHg, and 4.3 mmHg, respectively, which indicated good agreement. Introducing such wearable blood pressure sensors into daily medical practice gets detailed information on continuous blood pressure variation while examinees move freely and the resulting information is used for better quality control of adult diseases. It is also expected that wearable blood pressure sensors can be used in emergency medical cases, in intensive care, and at remote sites.

Arterial stiffness following repeated Valsalva maneuvers and resistance exercise in young men

2007 ◽  
Vol 32 (2) ◽  
pp. 257-264 ◽  
Author(s):  
Kevin S. Heffernan ◽  
Sae Young Jae ◽  
David G. Edwards ◽  
Erin E. Kelly ◽  
Bo Fernhall
Keyword(s):  
Blood Pressure ◽  
Mean Arterial Pressure ◽  
Arterial Stiffness ◽  
Arterial Pressure ◽  
Pulse Wave Velocity ◽  
Resistance Exercise ◽  
Pulse Wave ◽  
Lower Body ◽  
Peripheral Arterial ◽  
Finger Plethysmography

The purpose of this study was to compare arterial stiffness after a bout of resistance exercise (RE) and an experimental condition consisting of repeated Valsalva maneuvers (VMs). Fourteen male participants randomly completed a lower-body, unilateral RE bout and a VM bout designed to alter blood pressure (BP) in a similar pulsatile fashion. Pulse-wave velocity (PWV, measured in metres per second (m·s–1)) was used to measure central and peripheral arterial stiffness and was assessed before and 20 min after each perturbation. Beat-to-beat blood pressure (BP) was assessed during bouts using finger plethysmography. Change in systolic BP, diastolic BP, mean arterial pressure, and pulse pressure were similar during both bouts. Central PWV increased after repeated VMs (7.1 ± 0.3 m/s to 7.8 ± 0.3 m/s), but not after RE (7.2 ± 0.3 m/s to 7.2 ± 0.3 m/s) (interaction, p = 0.032). There was no change in peripheral PWV after VM (8.9 ± 0.3 m/s to 9.3 ± 0.3 m/s) or RE (8.5 ± 0.2 m/s to 8.4 ± 0.2 m/s). Arterial stiffness increased after repeated VM. Even though presented with a similar BP load, arterial stiffness did not increase after acute RE. These findings suggest a role for VM in acutely altering arterial properties.

Aortic Distensibility in Patients with Cerebrovascular Disease

1995 ◽  
Vol 89 (3) ◽  
pp. 247-253 ◽  
Author(s):  
E. D. Lehmann ◽  
K. D. Hopkins ◽  
R. L. Jones ◽  
A. G. Rudd ◽  
R. G. Gosling
Keyword(s):  
Blood Pressure ◽  
Pulse Wave Velocity ◽  
Wave Velocity ◽  
Pulse Wave ◽  
Aortic Distensibility ◽  
Control Group ◽  
Aortic Compliance ◽  
Stroke Patients ◽  
Non Invasive ◽  
Control Subjects

1. Non-invasive aortic compliance measurements have been used previously to assess the distensibility of the aorta in several pathological conditions associated with increased cardiovascular risk. We set out to establish whether aortic compliance is abnormal in patients with stroke. 2. Pulse wave velocity measurements of thoracoabdominal aortic compliance were made in 20 stroke patients and 25 age- and sex-matched hospitalized, non-stroke control subjects putatively free of cardiovascular disease. Since compliance varies with non-chronic changes in blood pressure, a blood pressure corrected index of aortic distensibility, Cp, was calculated. 3. Aortic compliance was significantly reduced in patients with stroke compared with non-stroke control subjects (0.46 ± 0.27 versus 0.86 ± 0.34%/10 mmHg, P < 0.0002), corresponding with higher values for pulse wave velocity. Stroke patients also had significantly higher systolic and diastolic blood pressures (P < 0.02 and P < 0.002 respectively) and total cholesterol levels (P < 0.004) than the control subjects. Calculation of Cp did not alter the observation of stiffer aortas in the stroke cohort (P < 0.0007). 4. In both stroke patient and control cohorts, as expected, inverse trends were observed between aortic compliance and blood pressure. Also as expected, in the control group Cp values did not show a relationship with blood pressure (r = 0.02, P = 0.092, not significant). However, in the stroke cohort a marked dependence of Cp on blood pressure was observed (r = −0.48, P = 0.03). 5. Transoesophageal echocardiographic studies have recently identified advanced atherosclerosis in the ascending aorta as a possible source of cerebral emboli and an independent risk factor for ischaemic stroke. Our observations of significantly stiffer thoracoabdominal aortas in patients with stroke lead us to hypothesize that a totally non-invasive assessment of aortic compliance may potentially prove a useful surrogate marker of such atherosclerotic risk. 6. Blood pressure-corrected indices of arterial elastic properties based on normotensive models are widely applied in the literature. Our observation that these indices exhibit a considerable blood pressure dependence leads us to urge caution in the use of such corrections, especially in hypertensive patients.

OS 14-07 PULSE WAVE VELOCITY COMPARED WITH MEAN ARTERIAL PRESSURE AND PULSE PRESSURE PROGNOSTIC IN THE POPULATION OF GAOYOU COUNTY, CHINA

2016 ◽  
Vol 34 (Supplement 1) ◽  
pp. e213-e214
Author(s):  
Yichao Lu ◽  
Haifeng Zhang ◽  
Fang Zhou ◽  
Shan-Shan Li ◽  
Fang-Fei Wei ◽  
...  
Keyword(s):  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Pulse Wave Velocity ◽  
Wave Velocity ◽  
Pulse Pressure ◽  
Pulse Wave

Abstract 184: Aortic Pulse Wave Velocity Does Not Correlate with Flow Wave Velocity or Mean Arterial Pressure in Robust, in Vitro Cardiovascular Hemodynamic Simulation

2012 ◽  
Vol 32 (suppl_1) ◽  
Author(s):  
Jeffrey Lillie ◽  
Doran Mix ◽  
Karl Schwarz ◽  
Ankur Chandra ◽  
Steven Day ◽  
...  
Keyword(s):  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Pulse Wave Velocity ◽  
Wave Velocity ◽  
Systolic Hypertension ◽  
Pulse Wave ◽  
Isolated Systolic Hypertension ◽  
Pulsed Wave Doppler ◽  
Ventricular Ejection Time ◽  
The Relationship

Introduction: Arterial compliance is a marker for cardiac burden in atherosclerotic disease, with the pressure Pulse Wave Velocity (PWV) correlated to compliance. Current clinical practice employs pulsed wave Doppler to measure Flow Wave Velocity (FWV) as a surrogate of PWV. We hypothesized that PWV and FWV are not directly related and are affected by left ventricular ejection time (LVET). Furthermore, we proposed that aortic PWV is independent of mean arterial pressure (MAP) in the setting of isolated systolic hypertension. Methods: Using a physiologically accurate electromechanical cardiovascular simulator, two solid state manometer-tipped pressure transducers and two transit time flow sensors were located at the aortic root and at the aortic bifurcation. PWV and FWV were directly measured while individually varying contractility and thus LVET. The experiments were repeated at various systemic vascular resistances (SVR) and vascular compliances. Automated signal processing and data extraction techniques were used to calculate the key parameters. Results: As LVET increased, FWV decreased but PWV increased while MAP remained constant for a fixed SVR and compliance. (Figure 1) This trend held consistent at different SVR’s and compliances. The relationship of PWV and FWV with LVET appeared to be exponential and linear respectively. For a constant MAP, the associated PWV varied by up to 50m/s and FWV by up to 10m/s for a change in LVET of 225ms. Conclusions: In conclusion, our data shows that PWV and FWV appear to be inversely related. Our data also suggest that PWV and FWV are independent of MAP in the setting of isolated systolic hypertension. These findings suggest that FWV measured by pulsed wave Doppler may not be a simple surrogate for true PWV. Future work is needed to elucidate the hemodynamic principals governing the relationship between PWV and FWV.

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