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1 Hydraulics Laboratory, Institute of Biomedical Technology, University of Gent, 9000 Gent, Belgium; 2 The Cleveland Clinic Foundation, Cleveland, Ohio 44195; 3 Norwegian University of Science and Technology, Trondheim, Norway; and 4 Cardiology Department, University Hospital, University of Gent, Belgium
We fitted a
three-segment transmission line model for the radial-carotid/aorta
pressure transfer function (TFF) in 31 controls and 30 patients with
coronary artery disease using noninvasively measured (tonometry) radial
and carotid artery pressures (Pcar). Except for the distal
reflection coefficient (0.85 ± 0.21 in patients vs. 0.71 ± 0.25 in controls; P < 0.05), model parameters were not
different between patients or controls. Parameters were not related to
blood pressure, age, or heart rate. We further assessed a
point-to-point averaged TFF (TFFavg) as well as upper
(TFFmax) and lower (TFFmin) enveloping TFF.
Pulse pressure (PP) and augmentation index (AIx) were derived on
original and reconstructed Pcar (Pcar,r). TFFavg yielded closest morphological agreement between
Pcar and Pcar,r (root mean square = 4.3 ± 2.3 mmHg), and TTFavg best predicted PP
(41.5 ± 11.8 vs. 41.1 ± 10.0 mmHg measured) and AIx
(
0.02 ± 0.19 vs. 0.01 ± 0.19). PP and AIx, calculated
from Pcar or Pcar,r, were higher in patients
than in controls, irrespectively of the TFF used. We conclude that
1) averaged TFF yield significant discrepancies between
reconstructed and measured pressure waveforms and subsequent derived
AIx; and 2) different TFFs seem to preserve the information in the pressure wave that discriminates between controls and patients.
blood pressure; model; applanation tonometry
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