TY - JOUR
T1 - Pulse pressure, arterial compliance and wave reflection under differential vasoactive and mechanical loading
AU - Li, John K.J.
AU - Zhu, Ying
AU - Geipel, Pamela S.
N1 - Funding Information:
Acknowledgments This work was supported in part by a grant from the American Heart Association and New Jersey Commission on Spinal Cord Research.
PY - 2010/12
Y1 - 2010/12
N2 - Similar pulse pressure increases and flow reductions have been reported by many investigators, despite dissimilar forms of arterial loading applied. Increased vascular load is most commonly observed due to mechanical and vasoactive interventions. The present study intended to differentiate the hemodynamic contributions of these two forms of arterial loading at closely matched blood pressure levels. To accomplish this, proximal aortic characteristic impedance (Zo), total arterial compliance (C), peripheral vascular resistance (Rs) and time-domain resolved forward (Pf) and reflected (Pr) waves were obtained in six anesthetized, thoracotomized and ventilated dogs. Acute loading was accomplished by brief descending thoracic aorta (DTA) occlusion or by intravenous bolus infusion of methoxamine (MTX:5 mg/ml) Systolic pressure increases were matched to a similar extent. Results showed that pulse pressures were drastically increased, reflecting large increases in wave reflections and decreases in arterial compliances. Changes in Zo, Rs and C were quantitatively different between the two forms of loading. DTA occlusion primarily increased Zo and Rs with a concurrently large reduction in C. MTX infusion significantly increased small vessel Rs to the same extent as DTA occlusion, but with a slight decrease in C secondary to an increase in pressure, with Zo unchanged. Examination of dynamic loading showed similar increases in reflection coefficients, but Pf and Pr were qualitatively different. We conclude that vasoactive methoxamine infusion provides primarily an increased resistive load, while mechanical DTA occlusion provides an increased complex load to the left ventricle. These loads also occur earlier and variably during ventricular ejection.
AB - Similar pulse pressure increases and flow reductions have been reported by many investigators, despite dissimilar forms of arterial loading applied. Increased vascular load is most commonly observed due to mechanical and vasoactive interventions. The present study intended to differentiate the hemodynamic contributions of these two forms of arterial loading at closely matched blood pressure levels. To accomplish this, proximal aortic characteristic impedance (Zo), total arterial compliance (C), peripheral vascular resistance (Rs) and time-domain resolved forward (Pf) and reflected (Pr) waves were obtained in six anesthetized, thoracotomized and ventilated dogs. Acute loading was accomplished by brief descending thoracic aorta (DTA) occlusion or by intravenous bolus infusion of methoxamine (MTX:5 mg/ml) Systolic pressure increases were matched to a similar extent. Results showed that pulse pressures were drastically increased, reflecting large increases in wave reflections and decreases in arterial compliances. Changes in Zo, Rs and C were quantitatively different between the two forms of loading. DTA occlusion primarily increased Zo and Rs with a concurrently large reduction in C. MTX infusion significantly increased small vessel Rs to the same extent as DTA occlusion, but with a slight decrease in C secondary to an increase in pressure, with Zo unchanged. Examination of dynamic loading showed similar increases in reflection coefficients, but Pf and Pr were qualitatively different. We conclude that vasoactive methoxamine infusion provides primarily an increased resistive load, while mechanical DTA occlusion provides an increased complex load to the left ventricle. These loads also occur earlier and variably during ventricular ejection.
KW - Aortic occlusion
KW - Arterial compliance
KW - Methoxamine infusion
KW - Pulse pressure
KW - Ventricular afterload
KW - Wave reflection
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U2 - 10.1007/s10558-010-9107-y
DO - 10.1007/s10558-010-9107-y
M3 - Article
C2 - 21153486
AN - SCOPUS:79952707167
VL - 10
SP - 170
EP - 175
JO - Cardiovascular Engineering
JF - Cardiovascular Engineering
SN - 1567-8822
IS - 4
ER -