info@chennaimedipoint.com

Aortic pressure, Pulse Wave Velocity and Arterial stiffness

Categories

The Problem

Aortic pressure

Studies have shown that decrease in Aortic pressure leads to improved CV outcomes and lesser deaths. It is also known that the aortic pressure gets increased because of faster wave reflections arising out of increased pulse wave velocities. This increased pulse wave velocity is caused not only by hypertension but also by other risk factors that affect endothelial dysfunction. Therefore, monitoring of pulse wave velocity is important in monitoring the effect of therapy in all patients.

 

It is well documented that endothelial dysfunction is the precursor to all forms of CV Disease. It is also known that endothelial dysfunction arises because of various risk factors – both hidden and apparent. Increasing endothelial dysfunction leads to decreased NO production and lower artery contractility eventually leading to high arterial stiffness. Arterial stiffness causes the pulse wave to travel faster and thereby increasing the pulse wave velocity. This leads to faster wave reflections which increase the Aortic pressure.

 

Aortic root pressure gradient is composed by two major components

 

1. Systolic Pressure gradient – During the systole, the Left Ventricular pressure contributes to a rapid peak at the aortic root. This pressure also falls rapidly as the left Ventricle is emptied into the Aorta. This gradient does not contribute to the Aortic root pressure during diastole.

 

2. Diastolic Pressure gradient – As the rapid pressure pulse propagates through the entire arterial structure, it is resisted by the systemic vascular resistance from the branches. This resistance creates a virtual back pressure wave towards the Aortic root. This back pressure adds up from the branches and an equivalent reflected wave is experienced at the aortic root.

 

 

The Aortic root pressure is thus directly dependent on two components viz. LV Systolic pressure and reflected pressure waveform.

 

The timing of reflected pressure waveform is dependent on the arterial stiffness. Since the Pulse wave velocity is proportional to the arterial stiffness, the reflected pressure wave takes lesser and lesser time to reach the Aortic root. Hence, as the arterial stiffness goes on increasing, the reflected wave reaches earlier to the aortic root.

 

The reflected wave is superimposed on the Systolic wave if the pulse wave velocity is large. Thus the resultant Aortic root pressure increases in proportion with the arterial stiffness.

Measurements

 

The device uses Brachial Blood pressure and Carotid Femoral PWV to find out the Aortic root pressure.

 

It is based on the mathematical analysis of Invasive Aortic pressure values with respect to the Brachial Blood pressure and pulse wave velocity found non-invasively.  Aortic root pressure values are directly proportional to a combination of both the Brachial pressure value and Carotid femoral Pulse wave velocity. A significant correlation was found in these parameter values when multivariate regression analysis was carried out. Equation relating aortic pressure value, brachial pressure and CFPWV with respective coefficients was derived from this.

The senior management consists of a marketing expert (a former National Sales Manager of Ranbaxy), a biomedical engineer and an experienced sales manager.

Read more

Location

Chennai Medipoint Pvt. Ltd.

#C-19, 1st Floor, Guindy Industrial Estate,

Chennai 600 032, Tamil Nadu, India.

Phone: +91-44-22501157

Mobile: +91-96866 82520, +91-99020 11609

Email: info@chennaimedipoint.com

Web: www.chennaimedipoint.com

© 2014 CHENNAI MEDIPOINT. ALL RIGHTS RESERVED.