P11.5 Cardiac and Vascular Tissue Properties Determine the Central Blood Pressure Waveform: Consequences for Pulse Wave Analysis

• Published in: Artery research Vol. 8; no. 4; pp. 161 - 162
• Main Authors: Heusinkveld, M., Spronck, B., Lumens, J., Delhaas, T., Hughes, A., Reesink, K.
• Format: Journal Article
• Language: English
• Published: Dordrecht Springer Netherlands 2014; Springer Nature B.V; BMC
• Subjects: Blood pressure; Poster Abstract Presentations
• ISSN: 1872-9312; 1876-4401; 1876-4401
• DOI: 10.1016/j.artres.2014.09.223

Various methods exist to estimate central blood pressure (BP) waveforms from noninvasive peripheral BP measurements. Most methods consider only vascular effects and are based on population reference data and oversimplified boundary conditions. Because contractile properties of the heart may play a role as well, we investigated by means of a computational model the isolated and combined influences of cardiac properties as well as vascular stiffening on the central BP waveform.
A model of the circulation (Arts et al.2005, AJP-Heart) was used to simulate central and peripheral BP waveforms from the left ventricle (LV) to femoral and radial arteries. We investigated the effect on BP waveforms of 1) a 50% reduction in the shortening velocity (v-s) of LV sarcomeres and 2) a vascular stiffness increase, corresponding to an increase in carotid-femoral pulse wave velocity from 8.6m/s to 10.2m/s. Central BP waveforms were characterized using augmentation index (AIx, based on the 2nd derivative) and pulse pressure (PP).
We obtained realistic BP waveforms for LV, central and peripheral vessels. Reducing v-s (all else equal) caused AIx to increase from respectively 16% (PP=60mmHg) to 30% (PP=60mmHg). Vascular stiffening (all else equal) resulted in an AIx increase from 16% to 36% and an increase in PP from 60 to 100mmHg. Combined reduced v and vascular stiffening resulted in an AIx of 42% with a PP of 80mmHg.
Not only vascular, but also cardiac properties influence the central BP waveform. We conclude that heart-vessel interaction should be considered in pulse wave analysis.