Circulation, Vol 72, 1257-1269, Copyright © 1985 by American Heart Association
RD Latham, N Westerhof, P Sipkema, BJ Rubal, P Reuderink and JP Murgo
The human aorta and its terminal branches were investigated in normal
subjects during elective cardiac catheterization to evaluate regional wave
travel and arterial wave reflections. A specially designed catheter with
six micromanometers equally spaced at 10 cm intervals was positioned with
the tip sensor in the distal external iliac artery and the proximal sensor
in the aortic arch. Simultaneous pressures were obtained and analyzed for
foot-to-foot wave velocity, and Fourier analysis was used to derive
apparent phase velocity. These quantities were assessed during control (n =
9), during Valsalva (n = 8) and Muller (n = 4) maneuvers, and during
femoral artery occlusion by bilateral manual compression (n = 8). During
control, regional cross- sectional areas, determined from aortography, and
regional foot-to-foot pulse wave velocities were used to calculate the
local reflection coefficient in the proximal descending aorta (gamma =
0.05), at the junction of the renal arteries (gamma = 0.43), and at the
terminal aortic bifurcation (gamma = 0.13). To test the hypothesis that
significant reflections originate in the aorta, at the level of the renal
arteries, aortograms were used to design a latex tube model with geometric
properties similar to the descending aorta. Velocities and reflection
characteristics in the model and in vivo were compared. Inspection of
thoracic aortic pressures under control conditions revealed a reflected
wave originating from the region of the aorta at the level of the renal
arterial branches while abdominal pressures exhibited reflection from a
site peripheral to the terminal aortic bifurcation. In the low frequency
range, apparent phase velocity was found to be higher proximal to the renal
arteries as compared with at the distal sites. In addition, the minimum
value occurred at a higher frequency in the lower thoracic aorta than at
more distal sites. The effects of reflection on apparent wave velocity in
the tube model were consistent with data obtained in vivo. The Valsalva
maneuver diminished the reflection from the aortic region of the renal
arteries, thus allowing the distal reflected wave to become more evident on
the thoracic pressure waveforms. Bilateral femoral artery occlusion usually
enhanced the distal reflection and the Muller maneuver usually resulted in
small increases in reflections. In conclusion, the geometric and elastic
nonuniformity of the aorta results in two major sites of arterial wave
reflection that influence the aortic pressure waveforms in man.(ABSTRACT
TRUNCATED AT 400 WORDS)
ARTICLES
Regional wave travel and reflections along the human aorta: a study with six simultaneous micromanometric pressures
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