Changes in left ventricular ejection time but not peripheral resistance alter carotid and femoral waveform shape, impacting on measured carotid-femoral pulse wave velocity: a modelling study

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Abstract

Background: Large artery stiffness, a cardiovascular risk factor, is blood pressure and heart rate (HR) dependent. However, the effects of waveform input (for example, left ventricular ejection time, LVET) and wave reflection (for example, changes in peripheral resistance) are harder to elucidate. Aims: To quantify the effect of LVET and peripheral resistance changes on carotid-femoral pulse wave velocity (cfPWV), a measure of large artery stiffness, through a computational model. Methods: Using a transmission line model of the human arterial tree, changes in HR (60– 100 bpm), LVET (0.1–0.45 s) at a fixed HR of 70 bpm, and peripheral resistance (50–150%) were modelled and the blood pressure waveform at the carotid and femoral sites generated for a static elastic modulus (non-pressure and non-frequency dependent). cfPWV was calculated using waveform shape methods as applied in the clinic (intersecting tangents, maximum systolic upstroke) and by calculation of the phase velocity. Results: Without a dynamic elastic component of elasticity, cfPWV was not dependent on HR, but increased significantly with increasing LVET (0.17±0.22 m/s per 50 ms) when calculated using the intersecting tangents or systolic upstroke method. Correlation of cfPWV with peripheral resistance was strong, but the magnitude of the dependency was low (0.03±0.01 to 0.05±0.05 m/s per 10% increase in resistance) when calculated by the intersecting tangent or systolic upstroke method. When cfPWV was calculated using phase velocity (independent of blood pressure waveform shape), the expected zero dependency on LVET or peripheral resistance was identified. Conclusion: Increased LVET causes changes in blood pressure waveform shape that increased cfPWV if measured by the intersecting tangents or maximum systolic upstroke methods. Changes in HR (without accounting for viscoelasticity) and changes in peripheral resistance (indep
Original languageEnglish
Pages (from-to)e35-e36
Number of pages2
JournalHypertension
Volume69
Issue number6
Publication statusPublished - 2017
Event38th Annual Scientific Meeting of the High Blood Pressure Research Council of Australia - Hobart, Australia
Duration: 7 Dec 201610 Dec 2016

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