Waveform dispersion, not reflection, may be the major determinant of aortic pressure wave morphology

• Published in: American journal of physiology. Heart and circulatory physiology 2005-12, Vol.289 (6), p.H2497-H2502
• Main Authors: Hope, Sarah A, Tay, David B, Meredith, Ian T, Cameron, James D
• Format: Article
• Language: English
• Subjects: Aorta - physiopathology; Blood Pressure; Blood Pressure Determination - methods; Cardiovascular Diseases - diagnosis; Cardiovascular Diseases - physiopathology; Diagnosis, Computer-Assisted - methods; Female; Fourier Analysis; Humans; Male; Risk Assessment - methods; Risk Factors; Severity of Illness Index
• ISSN: 0363-6135; 1522-1539
• DOI: 10.1152/ajpheart.00411.2005

1 Cardiovascular Research Centre, Monash Medical Centre, 2 Monash University, and 3 La Trobe University, Melbourne, Victoria, Australia Submitted 25 April 2005 ; accepted in final form 13 July 2005 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 ( T i ), and pressure parameters. AI decreased progressively between the aortic root and bifurcation ( P < 0.001), and T i 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 T i 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. augmentation index; pressure wave reflection; Fourier analysis; aorta Address for reprint requests and other correspondence: J. D. Cameron, Cardiovascular Research Centre, Monash Medical Centre, 246 Clayton Rd., Clayton, Victoria 3168, Australia (e-mail: James.Cameron{at}med.monash.edu.au )