Estimation of total systemic arterial compliance in humans

1990 ◽  
Vol 69 (1) ◽  
pp. 112-119 ◽  
Author(s):  
W. K. Laskey ◽  
H. G. Parker ◽  
V. A. Ferrari ◽  
W. G. Kussmaul ◽  
A. Noordergraaf
Keyword(s):  
Heart Failure ◽  
Diastolic Pressure ◽  
Arterial Compliance ◽  
Aortic Pressure ◽  
Arterial System ◽  
Idiopathic Dilated Cardiomyopathy ◽  
Windkessel Model ◽  
Failure Group ◽  
Control Subjects ◽  
Total Arterial Compliance

Systemic arterial compliance, a major component of aortic input impedance, was determined in 10 patients with congestive heart failure secondary to idiopathic dilated cardiomyopathy and 11 age-matched control subjects found free of detectable cardiovascular disease. Total arterial compliance was determined from high-fidelity ascending aortic pressure and velocity recordings using 1) the traditional monoexponential aortic diastolic pressure decay and 2) the direct solution of the equation, which describes the three-element windkessel model of the arterial system. Resting values for total arterial compliance (x10(-3) cm5/dyn) derived from method 1 were significantly correlated with compliance derived from method 2 (r = 0.89, P less than 0.01). However, method 1 values (control mean 1.15 +/- 0.27, heart failure mean 1.18 +/- 0.54) were consistently and significantly lower (P less than 0.001) than method 2 values (control mean 1.59 +/- 0.50, heart failure mean 1.38 +/- 0.60). Resting total arterial compliance in heart-failure patients was not significantly different from control subjects. Total arterial compliance did not significantly change with exercise in either group despite increases in arterial pressure. However, nitroprusside administration in the heart-failure group increased total arterial compliance both at rest and on exercise compared with the unmedicated state. These different methodological approaches to the estimation of total arterial compliance in humans resulted in significantly different absolute values for compliance, although both methods provided concordant results with respect to the response of arterial compliance to physiological and pharmacological interventions.(ABSTRACT TRUNCATED AT 250 WORDS)

Estimation of total arterial compliance: an improved method and evaluation of current methods

1986 ◽  
Vol 251 (3) ◽  
pp. H588-H600 ◽  
Author(s):  
Z. Liu ◽  
K. P. Brin ◽  
F. C. Yin
Keyword(s):  
Diastolic Pressure ◽  
Arterial Compliance ◽  
Aortic Pressure ◽  
Arterial System ◽  
Windkessel Model ◽  
Total Arterial Compliance ◽  
Improved Methods ◽  
Mean Aortic Pressure

Determination of arterial compliance in vivo has long interested physiologists. Most current methods for estimating this parameter assume that compliance is constant, i.e., that arterial pressure-volume (P-V) relations are linear, and they also assume that diastolic aortic pressure decay is an exponential function of time. Both of these assumptions, however, are questionable. This study proposes improved methods of estimating compliance based on a Windkessel model of the arterial system but which utilize the area under the pressure tracing rather than the waveform itself. Formulations accounting for both linear and three hypothetical nonlinear arterial P-V relations (exponential, logarithmic, and parabolic) are presented. Data from patients with congestive heart failure and hypertension are used for illustration. Compliances assuming linear P-V relations are reasonably close to those assuming nonlinear P-V relations only at mean aortic pressure. At end-diastolic pressure the linear assumption underestimates and at peak systolic it overestimates the compliances obtained assuming nonlinear P-V relations. The simpler linear assumption still allows a first approximation to compliance, but we show that existing methods for obtaining compliance under this assumption have severe theoretical as well as practical shortcomings. Our proposed method avoids these shortcomings primarily because deviations from an exact exponential form of the pressure wave have less influence on these compliance estimates than currently used methods.

Use of pulse pressure method for estimating total arterial compliance in vivo

1999 ◽  
Vol 276 (2) ◽  
pp. H424-H428 ◽  
Author(s):  
N. Stergiopulos ◽  
P. Segers ◽  
N. Westerhof
Keyword(s):  
Pulse Pressure ◽  
Diastolic Pressure ◽  
Arterial Compliance ◽  
Aortic Pressure ◽  
Lower Limbs ◽  
Pressure Method ◽  
Total Arterial Compliance ◽  
The Difference ◽  
Pulse Pressure Method

We determined total arterial compliance from pressure and flow in the ascending aorta of seven anesthetized dogs using the pulse pressure method (PPM) and the decay time method (DTM). Compliance was determined under control and during occlusion of the aorta at four different locations (iliac, renal, diaphragm, and proximal descending thoracic aorta). Compliance of PPM gave consistently lower values (0.893 ± 0.015) compared with the compliance of DTM (means ± SE; r = 0.989). The lower compliance estimates by the PPM can be attributed to the difference in mean pressures at which compliance is determined (mean pressure, 81.0 ± 3.6 mmHg; mean diastolic pressure, over which the DTM applies, 67.0 ± 3.6 mmHg). Total arterial compliance under control conditions was 0.169 ± 0.007 ml/mmHg. Compliance of the proximal aorta, obtained during occlusion of the proximal descending aorta, was 0.100 ± 0.007 ml/mmHg. Mean aortic pressure was 80.4 ± 3.6 mmHg during control and 102 ± 7.7 mmHg during proximal descending aortic occlusion. From these results and assuming that upper limbs and the head contribute as little as the lower limbs, we conclude that 60% of total arterial compliance resides in the proximal aorta. When we take into account the inverse relationship between pressure and compliance, the contribution of the proximal aorta to the total arterial compliance is even more significant.

Estimating arterial resistance and compliance during transient conditions in humans

1989 ◽  
Vol 257 (1) ◽  
pp. H190-H197 ◽  
Author(s):  
F. C. Yin ◽  
Z. R. Liu
Keyword(s):  
Pressure Difference ◽  
Arterial Compliance ◽  
Quantitative Difference ◽  
Peripheral Resistance ◽  
Aortic Pressure ◽  
Hemodynamic Parameters ◽  
Windkessel Model ◽  
Total Arterial Compliance ◽  
Highly Correlated ◽  
Almost All

Almost all existing methods for estimating hemodynamic parameters are valid only during steady-state conditions. There is often a need, however, for estimating peripheral resistance and total arterial compliance during beat-to-beat transients such as during atrial fibrillation. During such transients the pressure at the onset and end of a cardiac cycle usually differ. This pressure difference necessitates a modification of usual methods used for estimating these hemodynamic parameters. In this paper we formulate a method for estimating resistance and total arterial compliance during such beat-to-beat transients. For simplicity the expressions are derived for a two-element windkessel model of the circulation. The method is a generalization of one we previously proposed. Rather than using parameter estimation techniques or having to assume a monoexponential pressure decay during diastole, our method uses the areas under the systolic and diastolic portions of the aortic pressure versus time tracing to obtain explicit expressions for compliance; both for the case where it is constant and when it is assumed to be nonlinear (exponential) function of pressure. Aortic pressure and flow data from patients undergoing cardiac catheterization are employed to illustrate the method. Results illustrate the quantitative difference between uncorrected and corrected estimates of both resistance and compliance as a function of the pressure difference between the onset and end of each beat. The uncorrected parameters were found to be linearly and highly correlated with these pressure differences. Regressions of pressure difference against normalized values revealed that the pooled data for all patients defined a single relationship.(ABSTRACT TRUNCATED AT 250 WORDS)

Apparent arterial compliance

1998 ◽  
Vol 274 (4) ◽  
pp. H1393-H1403 ◽  
Author(s):  
Christopher M. Quick ◽  
David S. Berger ◽  
Abraham Noordergraaf
Keyword(s):  
Pulse Wave Velocity ◽  
Wave Velocity ◽  
Pulse Wave ◽  
Arterial Compliance ◽  
Complex Function ◽  
Peripheral Resistance ◽  
Aortic Pressure ◽  
Arterial System ◽  
Lumped Model ◽  
Total Arterial Compliance

Recently, there has been renewed interest in estimating total arterial compliance. Because it cannot be measured directly, a lumped model is usually applied to derive compliance from aortic pressure and flow. The archetypical model, the classical two-element windkessel, assumes 1) system linearity and 2) infinite pulse wave velocity. To generalize this model, investigators have added more elements and have incorporated nonlinearities. A different approach is taken here. It is assumed that the arterial system 1) is linear and 2) has finite pulse wave velocity. In doing so, the windkessel is generalized by describing compliance as a complex function of frequency that relates input pressure to volume stored. By applying transmission theory, this relationship is shown to be a function of heart rate, peripheral resistance, and pulse wave reflection. Because this pressure-volume relationship is generally not equal to total arterial compliance, it is termed “apparent compliance.” This new concept forms the natural counterpart to the established concept of apparent pulse wave velocity.

Comparison of linear and nonlinear formulations of the three-element windkessel model

1996 ◽  
Vol 271 (6) ◽  
pp. H2661-H2668 ◽  
Author(s):  
R. Fogliardi ◽  
M. Di Donfrancesco ◽  
R. Burattini
Keyword(s):  
Diastolic Pressure ◽  
Estimation Error ◽  
Aortic Pressure ◽  
Arterial System ◽  
Parameter Estimates ◽  
Model Parameters ◽  
Windkessel Model ◽  
Linear Version ◽  
Compliance Model ◽  
Better Than

The three-element windkessel model incorporating a constant compliance (model A) was compared with two nonlinear versions of the same model (models B1 and B2) incorporating a pressure-dependent compliance. The aim was to test whether nonlinear elasticity yielded better model behavior in describing ascending aortic pressure-flow relationships and interpreting the physical properties of the arterial system. Exponential and bell-shaped compliance vs. pressure curves were assumed in models B1 and B2, respectively. To test these models, we used measurements of ascending aortic pressure and flow from three dogs under a wide variety of hemodynamic states obtained by administering vasoactive drugs and by pacing the heart. These data involved pressure waves with and without an evident oscillation during diastole. Model parameters were estimated by fitting experimental and model-predicted ascending aortic pressures. Our results indicated that only models A and B1 were identifiable. Fits to ascending aortic pressure obtained from model B1 were significantly better than fits obtained from model A. However, 1) the accuracy of parameter estimates, as judged from parameter estimation error analysis, was better in model A than in model B1, 2) the estimates of characteristic parameters of the compliance vs. pressure relation in model B1 were inconsistent with expected physiological trends of this relation, and 3) model B1 did not improve the approximation of diastolic pressure in the presence of an evident oscillation. We conclude that, even in the presence of better data fit, the nonlinear three-element windkessel cannot be preferred over the traditional linear version of this model.

Sustained paradoxical vasodilation during orthostasis in heart failure: a factor in the edema pathogenesis?

1994 ◽  
Vol 267 (2) ◽  
pp. H443-H448 ◽  
Author(s):  
H. Wroblewski
Keyword(s):  
Heart Failure ◽  
Blood Flow ◽  
Dilated Cardiomyopathy ◽  
Regional Blood Flow ◽  
Functional Class ◽  
Idiopathic Dilated Cardiomyopathy ◽  
Pathophysiological Mechanism ◽  
Class Iii ◽  
Control Subjects ◽  
Subcutaneous Blood Flow

Baroreceptor-induced peripheral reflex vasoconstriction during upright posture is an important edema-prevention mechanism in humans. Congestive heart failure (CHF) has been associated with blunted baroreceptor control of regional blood flow during short-term head-up tilt. The effect of prolonged unloading of baroreceptors on subcutaneous blood flow of the calf was investigated in 12 healthy subjects and in 13 patients with severe idiopathic dilated cardiomyopathy (New York Heart Association functional class III or IV). The subjects were studied both supine and sitting for 3-h periods. When sitting, subcutaneous vascular resistance decreased -26 +/- 19% in CHF patients and increased 90 +/- 69% in control subjects (P < 0.0001). The corresponding subcutaneous blood flow increased 43 +/- 29% in patients with CHF compared with the decrease of -42 +/- 17% in control subjects (P < 0.0001). I conclude that patients with CHF secondary to idiopathic dilated cardiomyopathy have an abnormal baroreceptor-mediated peripheral vasodilation during orthostatic stress that is sustained for hours. This extended paradoxical vasodilation may participate as an additional pathophysiological mechanism contributing to lower extremity edema in patients with CHF.

Empirical estimates of mean aortic pressure: advantages, drawbacks and implications for pressure redundancy

2002 ◽  
Vol 103 (1) ◽  
pp. 7-13 ◽  
Author(s):  
Denis CHEMLA ◽  
Jean-Louis HÉBERT ◽  
Eduardo APTECAR ◽  
Jean-Xavier MAZOIT ◽  
Karen ZAMANI ◽  
...  
Keyword(s):  
Form Factor ◽  
Pulse Pressure ◽  
Wave Reflection ◽  
Diastolic Pressure ◽  
Augmentation Index ◽  
Aortic Pressure ◽  
Arterial System ◽  
Wave Amplification ◽  
Empirical Estimates ◽  
Alternative Formula

Mean arterial pressure (MAP) is estimated at the brachial artery level by adding a fraction of pulse pressure (form factor; = 0.33) to diastolic pressure. We tested the hypothesis that a fixed form factor can also be used at the aortic root level. We recorded systolic aortic pressure (SAP) and diastolic aortic pressure (DAP), and we calculated aortic pulse pressure (PP) and the time-averaged MAP in the aorta of resting adults (n = 73; age 43±14 years). Wave reflection was quantified using the augmentation index. The aortic form factor (range 0.35-0.53) decreased with age, MAP, PP and augmentation index (each P<0.001). The mean form factor value (0.45) gave a reasonable estimation of MAP (MAP = DAP+0.45PP; bias = 0±2mmHg), and the bias increased with MAP (P<0.001). An alternative formula (MAP = DAP+PP/3+5mmHg) gave a more precise estimation (bias = 0±1mmHg), and the bias was not related to MAP. This latter formula was consistent with the previously reported mean pulse wave amplification of 15mmHg, and with unchanged MAP and diastolic pressure from aorta to periphery. Multiple linear regression showed that 99% of the variability of MAP was explained by the combined influence of DAP and SAP, thus confirming major pressure redundancy. Results were obtained irrespective of whether the marked differences in heart period and extent of wave reflection between subjects were taken into account. In conclusion, the aortic form factor was strongly influenced by age, aortic pressure and wave reflection. An empirical formula (MAP = DAP+PP/3+5mmHg) that is consistent with mechanical principles in the arterial system gave a more precise estimate of MAP in the aorta of resting humans. Only two distinct pressure-powered functions were carried out in the (SAP, DAP, MAP, PP) four-pressure set.

Angiotensin II contributes to arterial compliance in congestive heart failure

2002 ◽  
Vol 283 (4) ◽  
pp. H1424-H1429 ◽  
Author(s):  
Silvia G. Lage ◽  
Liliane Kopel ◽  
Caio C. J. Medeiros ◽  
Ricardo T. Carvalho ◽  
Mark A. Creager
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Angiotensin Ii ◽  
Carotid Artery ◽  
Angiotensin Converting Enzyme ◽  
Arterial Compliance ◽  
Idiopathic Dilated Cardiomyopathy ◽  
Favorable Effect ◽  
Converting Enzyme ◽  
Patients With Heart Failure

Arterial compliance is determined by structural factors, such as collagen and elastin, and functional factors, such as vasoactive neurohormones. To determine whether angiotensin II contributes to decreased arterial compliance in patients with heart failure, this study tested the hypothesis that administration of an angiotensin-converting enzyme inhibitor improves arterial compliance. Arterial compliance and stiffness were determined by measuring carotid artery diameter, using high-resolution duplex ultrasonography, and blood pressure in 23 patients with heart failure secondary to idiopathic dilated cardiomyopathy. Measurements were made before and after intravenous administration of enalaprilat (1 mg) or vehicle. Arterial compliance was inversely related to both baseline plasma angiotensin II ( r = −0.52; P = 0.015) and angiotensin-converting enzyme concentrations ( r = −0.45; P = 0.041). During isobaric conditions, enalaprilat increased carotid artery compliance from 3.0 ± 0.4 to 5.0 ± 0.4 × 10−10N−1· m4( P = 0.001) and decreased the carotid artery stiffness index from 17.5 ± 1.8 to 10.1 ± 0.6 units ( P = 0.001), whereas the vehicle had no effect. Thus angiotensin II is associated with reduced carotid arterial compliance in patients with congestive heart failure, and angiotensin-converting enzyme inhibition improves arterial elastic properties. This favorable effect on the pulsatile component of afterload may contribute to the improvement in left ventricular performance that occurs in patients with heart failure treated with angiotensin-converting enzyme inhibitors.

Estimation of Forearm Arterial Compliance in Essential Hypertension: A Preliminary Report

1982 ◽  
Vol 63 (s8) ◽  
pp. 87s-88s ◽  
Author(s):  
A. CH. Simon ◽  
J. A. Levenson ◽  
S. P. Laurent ◽  
M. E. Safar
Keyword(s):  
Blood Flow ◽  
Essential Hypertension ◽  
Brachial Artery ◽  
Diastolic Pressure ◽  
Arterial Compliance ◽  
Normal Subjects ◽  
Arterial System ◽  
Flow Measurements ◽  
Blood Pressures ◽  
Blood Flow Measurements

1. Simultaneous brachial artery pressure and blood flow measurements were made in 21 men, including six normal subjects and 15 patients with essential hypertension of the same age and diastolic pressure at the time of investigation. 2. Blood flow was evaluated by means of a pulsed Doppler device with a double transducer probe, enabling a precise evaluation of the calibre of the brachial artery. From analysis of the pressure-flow curves during diastole, forearm arterial compliance was estimated by using an original first-order model of the forearm arterial system. 3. Forearm arterial compliance was significantly decreased in hypertensive subjects. 4. Since patients and hypertensive subjects had similar blood pressures, the results indicate that the reduced forearm compliance was independent of blood pressure per se but may reflect in hypertensive subjects adaptive changes in the walls of peripheral large arteries.

Normalized input impedance and arterial decay time over heart period are independent of animal size

1991 ◽  
Vol 261 (1) ◽  
pp. R126-R133 ◽  
Author(s):  
N. Westerhof ◽  
G. Elzinga
Keyword(s):  
Heart Rate ◽  
Decay Time ◽  
Input Impedance ◽  
Diastolic Pressure ◽  
Arterial Compliance ◽  
Characteristic Impedance ◽  
Peripheral Resistance ◽  
Arterial System ◽  
Heart Period ◽  
Arterial Tree

The arterial system of mammals in the weight range from 0.6 to 70 kg is characterized by the three-element windkessel, a succinct representation of the arterial tree consisting of the parameters peripheral resistance (Rp), total arterial compliance (C), and aortic characteristic impedance (Zc). The values of these parameters in resting conditions are related to body mass (M). The time constant, or decay time (tau), of the arterial system (defining rate of decay of aortic pressure in diastole), the product of Rp and C, is also evaluated. The dependencies of the heart period (T, inverse of heart rate), and durations of ejection (Ts) and of diastole (Td) in resting conditions are also determined as a function of M. It is found that Rp = Rp0M-0.93; Zc = Zc0M-0.97; and C = C0M+1.23, where Rp0, Zc0, and C0 are proportionality constants. Zc is thus a constant fraction of Rp in all mammals. tau is related to M as tau = tau 0M+0.29; T and Td are related to M as T = T0M+0.27 and Td = Td0M+0.30, where tau 0, T0, and Td0 are proportionality constants. The duration of diastole is thus a constant fraction of T, and the ratios T/tau and Td/tau are independent of M. The findings indicate that arterial input impedance, normalized to aortic Zc and plotted as a function of frequency normalized to heart rate, is similar for all mammals. The finding that the ratio Td/tau is the same in mammals (and Ts/T and stroke volume/M are constant) explains the constancy of pulse pressure (systolic minus diastolic pressure).(ABSTRACT TRUNCATED AT 250 WORDS)

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