Transmission delays of different portions of the arterial pulse. A comparison between the indirect aortic and carotid pulse tracings.
The transmission delays of the upstroke and incisura of the arterial pulse were measured in 128 normal subjects, divided in three groups of increasing age, by comparing the timing of the indirect aortic arch pulse (recorded at the suprasternal notch) (SSN) and the indirect, right carotid tracing (CAR). In the total group, the mean delay of the upstroke was 24.4 msec while the mean delay of the incisura was 19 msec (P less than 0.005). This difference was maximal in the oldest age group and became non significant in the group of children under 12. At slow heart rate, this difference was greater than at a more rapid heart rate. The left ventricular ejection times (LVET), measured on the two pulses, showed a very close correlation (r = 0.96) but the LVET was significantly longer in the SSN tracing, especially in the older subjects. These data reveal that the incisura of the arterial pulse travels more rapidly than the upstroke, especially in older patients and at lower heart rates. The most likely explanation of this fact resides in the frequency-dependent influence of vascular reflections, which is more important with increasing age and slower heart rate. Thus, the transmission velocity along the arterial wall is higher for the higher harmonics of the pulse wave (incisura) than for the lower harmonics (upstroke).
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D001013:Aorta, Thoracic / Q000502:physiology*; D001795:Blood Pressure Determination; D002339:Carotid Arteries / Q000502:physiology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006339:Heart Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction; D010701:Phonocardiography; D011674:Pulse; D013599:Systole