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1 Clinical Pharmacology, Faculty of Medicine, St. Mary's Hospital, Imperial College, London, United Kingdom
2 Physiological Flow Studies Group, Department of Bioengineering, Imperial College, London, United Kingdom
* To whom correspondence should be addressed. E-mail: andy.zambanini{at}medix-uk.com.
The study of wave propagation at different points in the arterial circulation may provide useful information regarding ventriculo-arterial interactions. We describe a number of haemodynamic parameters in the carotid, brachial and radial arteries of normal subjects using non-invasive techniques and wave intensity analysis (WIA). 21 normal adult subjects (14 men, mean age 44 ± 6 years) underwent applanation tonometry and pulsed wave Doppler studies of the right common carotid, brachial and radial arteries. Following ensemble-averaging of the pressure and flow-velocity data, local hydraulic work was determined and a pressure-flow velocity loop was used to determine local wave speed. WIA was then applied to determine the magnitude, timings and energies of individual waves. At all sites, forward traveling (S) and backward traveling (R) compression waves were observed in early systole. In mid- and late systole, forward traveling expansion waves (X,D) were also seen. Wave speed was significantly higher in the brachial (6.97 ± 0.58 m/s) and radial (6.78 ± 0.62 m/s) arteries compared with the carotid artery (5.40 ± 0.34 m/s; p<0.05). S wave energy was greatest in the brachial artery (993.5 ± 87.8 mJ/m2) but R wave energy was greatest in the radial (176.9 ± 19.9 mJ/m2). X wave energy was significantly higher in the brachial and radial arteries (176.4 ± 32.7 mJ/m2, 163.2 ± 30.5 mJ/m2) as compared with the carotid (41.0 ± 9.4 mJ/m2; p<0.001). WIA illustrates important differences in wave patterns between peripheral arteries and may provide a method for understanding ventriculo-arterial interactions in the time domain.
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