Artery Research

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Volume 20, Issue C, December 2017, Pages 78 - 78

P121 IDENTIFYING HAEMODYNAMIC DETERMINANTS OF PULSE PRESSURE: AN INTEGRATED NUMERICAL AND PHYSIOLOGICAL APPROACH

Authors
Samuel Vennin, Ye Li, Marie Willemet, Henry Fok, Haotian Gu, Peter Charlton, Jordi Alastruey, Phil Chowienczyk
King’s College London, UK
Available Online 6 December 2017.
DOI
10.1016/j.artres.2017.10.103How to use a DOI?
Abstract

Purpose: Hypertension, the single biggest killer worldwide1, arises mainly as a result of an increase in central pulse pressure (PP)2, yet haemodynamic basis of that increase is still disputed. We examined the ability of a simple “reduced” model comprising a proximal characteristic impedance linked to a Windkessel element to accurately predict PP from aortic blood flow and applied the model to examine PP dependence on cardiac and vascular properties.

Method: PP obtained from the model was compared with theoretical values obtained in silico and in vivo. Theoretical values were obtained using a distributed multi-segment model in a population of “virtual” subjects (n = 3,095) in which cardiovascular properties were varied over the pathophysiological range. In vivo measurements were in normotensive subject (n = 13) during modulation of physiology with vasoactive drugs with divergent actions on cardiac and cascular properties and in hypertensive subjects (n = 156).

Results: PP derived from the model agreed with theoretical values (mean difference SD, −0.09±1.96 mmHg) and with measured values (−1.95±3.74 and −1.18±3.67 mmHg for normotensive and hypertensive subjects respectively). Parameters extracted from the model agreed closely with theoretical and measured physical properties. PP was seen to be determined mainly by total arterial compliance (inversely associated with arterial stiffness) and ventricular dynamics: the volume of blood ejected up to time of pulse pressure and the rate of ventricular ejection up to this point.

Conclusion: Increased flow and/or volume accounted for 20.1 mmHg (52%) of the 39.0 mmHg difference in pulse pressure between the upper and lower tertiles of the hypertensive subjects.

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This is an open access article distributed under the CC BY-NC license.

References

1.SS Lim, T Vos, AD Flaxman, et al., A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010: A systematic analysis for the global burden of disease study 2010, Lancet, Vol. 380, 2012, pp. 2224-2260.
2.SS Franklin, W Gustin, ND Wong, MG Larson, MA Weber, WB Kannel, and D Levy, Hemodynamic patterns of age-related changes in blood pressure. The framingham heart study, Circulation, Vol. 96, 1997, pp. 308-315.
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Journal
Artery Research
Volume-Issue
20 - C
Pages
78 - 78
Publication Date
2017/12/06
ISSN (Online)
1876-4401
ISSN (Print)
1872-9312
DOI
10.1016/j.artres.2017.10.103How to use a DOI?
Open Access
This is an open access article distributed under the CC BY-NC license.

Cite this article

risenwbib
TY  - JOUR
AU  - Samuel Vennin
AU  - Ye Li
AU  - Marie Willemet
AU  - Henry Fok
AU  - Haotian Gu
AU  - Peter Charlton
AU  - Jordi Alastruey
AU  - Phil Chowienczyk
PY  - 2017
DA  - 2017/12/06
TI  - P121 IDENTIFYING HAEMODYNAMIC DETERMINANTS OF PULSE PRESSURE: AN INTEGRATED NUMERICAL AND PHYSIOLOGICAL APPROACH
JO  - Artery Research
SP  - 78
EP  - 78
VL  - 20
IS  - C
SN  - 1876-4401
UR  - https://doi.org/10.1016/j.artres.2017.10.103
DO  - 10.1016/j.artres.2017.10.103
ID  - Vennin2017
ER  -