Waveform dispersion, not reflection, may be the major determinant of aortic pressure wave morphology.
The objective of this study was to investigate the determinants of aortic pressure waveform morphology in the thoracoabdominal aorta with specific reference to features of potential prognostic value for cardiovascular disease. In particular, we aimed to determine the location of major pressure wave reflection sites within the aorta. Aortic pressure waveforms were acquired with 2-Fr Millar Mikro-tip catheter transducers in 40 subjects (26 men, 14 women), and repeated in 10 subjects, at five predetermined points within the aorta: aortic root, transverse arch, and at the levels of the diaphragm, renal arteries, and aortic bifurcation. Waveforms were analyzed for augmentation index (AI), time to inflection point (Ti), and pressure parameters. AI decreased progressively between the aortic root and bifurcation (P < 0.001), and Ti increased (P < 0.01). There was the expected progressive peripheral amplification of systolic and pulse pressures and fall in time to peak pressure (all P < 0.001). There was no difference on repeat pullback or between sexes. These data are at variance with the concept that central AI results solely from pressure wave reflection, when Ti would be expected to decrease and AI increase with distal progression. Pressure wave propagation phenomena may contribute, and the potential role of frequency dispersion merits investigation.
Hope
Sarah A
SA
Cardiovascular Research Centre, Monash Medical Centre, 246 Clayton Rd., Clayton, Victoria 3168, Australia.
Tay
David B
DB
Meredith
Ian T
IT
Cameron
James D
JD
D001011:Aorta / Q000503:physiopathology*; D001794:Blood Pressure; D001795:Blood Pressure Determination / Q000379:methods*; D002318:Cardiovascular Diseases / Q000175:diagnosis* / Q000503:physiopathology*; D003936:Diagnosis, Computer-Assisted / Q000379:methods*; D005260:Female; D005583:Fourier Analysis; D006801:Humans; D008297:Male; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D012720:Severity of Illness Index