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Am J Physiol Heart Circ Physiol 280: H1519-H1527, 2001;
0363-6135/01 $5.00
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Vol. 280, Issue 4, H1519-H1527, April 2001

Constructive and destructive addition of forward and reflected arterial pulse waves

Christopher M. Quick1, David S. Berger2, and Abraham Noordergraaf3

1 Center for Cerebrovascular Research, University of California, San Francisco, California 94110; 2 Cardiology Section, Department of Medicine, University of Chicago, Chicago, Illinois 60637; and 3 Cardiovascular Studies Unit, University of Pennsylvania, Philadelphia, Pennsylvania 19104-6392

Although the physics of arterial pulse wave propagation and reflection is well understood, there is considerable debate as to the effect of reflection on vascular input impedance (Zin), pulsatile pressure, and stroke work (SW). This may be related to how reflection is studied. Conventionally, reflection is experimentally abolished (thus radically changing unrelated parameters), or a specific model is assumed from which reflection can be removed (yielding model-dependent results). The present work proposes a simple, model-independent method to evaluate the effect of reflection directly from measured pulsatile pressure (P) and flow (Q). Because characteristic impedance (Z0) is Zin in the absence of reflection, the P with reflection theoretically removed can be calculated from Q · Z0. Applying this insight to an illustrative case indicates that reflection has the least effect on P and SW at normal pressure but a greater effect with vasodilation and vasoconstriction. Zin, P, and SW are increased or decreased depending on the relative amount of constructive and destructive addition of forward and reflected arterial pulse waves.

hemodynamics; modeling; wave propagation


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