Limitations and pitfalls of non-invasive measurement of arterial pressure wave reflections and pulse wave velocity

Patrick Segers; Jan Kips; Bram Trachet; Abigail Swillens; Sebastian Vermeersch; Dries Mahieu; Ernst Rietzschel; Marc De Buyzere; Luc Van Bortel

doi:10.1016/j.artres.2009.02.006

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Volume 3, Issue 2, June 2009, Pages 79 - 88

Limitations and pitfalls of non-invasive measurement of arterial pressure wave reflections and pulse wave velocity

Authors

Patrick Segers^a^{, *}, Jan Kips^a^{, b}, Bram Trachet^a, Abigail Swillens^a, Sebastian Vermeersch^a, Dries Mahieu^b, Ernst Rietzschel^c, Marc De Buyzere^c, Luc Van Bortel^b

^aBiofluid, Tissue and Solid Mechanics for Medical Applications, IBiTech, Ghent University, De Pintelaan 185, B-9000 Gent, Belgium

^bHeymans Institute of Pharmacology, Ghent University Hospital, Belgium

^cDepartment of Cardiovascular Diseases, Ghent University Hospital, Belgium

^*Corresponding author. Tel.: +32 9 2403466; fax: +32 9 2404159. E-mail address: patrick.segers@ugent.be (P. Segers).

Corresponding Author

Patrick Segers

Received 2 December 2008, Revised 9 February 2009, Accepted 23 February 2009, Available Online 19 March 2009.

DOI: 10.1016/j.artres.2009.02.006 How to use a DOI?
Keywords: Arterial stiffness; Hemodynamics; Wave reflection; Aorta; Pulse wave velocity; Augmentation index
Abstract: In this paper, we briefly revise some of the most widely applied methods to non-invasively assess pressure wave reflection (augmentation index) and arterial stiffness (pulse wave velocity; PWV) in clinical vascular research. It is clear that the pressure waveform alone provides insufficient information to accurately quantify the magnitude of pressure wave reflection or to even fully interpret its nature. A major difficulty arises from the identification of timing of return of the reflected pressure wave, the “fiducial” point, and incorrect assessment of this point has an effect on all of the derived parameters. From our studies, it also follows that the use of an approximated flow waveform has little or no added value to assess magnitude of wave reflection. As for PWV, carotid–femoral pulse wave velocity is currently considered as the gold standard method, although accurate assessment of travel distance remains ambiguous. New methods have also been suggested for the assessment of PWV, relying on the concept that the pressure wave is composed of one single forward wave and one single reflected wave, originating from a single reflection site. This simple conceptual scheme is no more than a paradigm for a complex physical reality of wave transmission and continuous reflections in a complex branching network of elastic vessels and the accuracy of these methods is very limited. As such, the benefit of the ease of use of these methods should be weighted against the desired accuracy and reliability.
Open Access: This is an open access article distributed under the CC BY-NC license.

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Journal: Artery Research
Volume-Issue: 3 - 2
Pages: 79 - 88
Publication Date: 2009/03/19
ISSN (Online): 1876-4401
ISSN (Print): 1872-9312
DOI: 10.1016/j.artres.2009.02.006 How to use a DOI?
Open Access: This is an open access article distributed under the CC BY-NC license.

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ris enw bib

TY  - JOUR
AU  - Patrick Segers
AU  - Jan Kips
AU  - Bram Trachet
AU  - Abigail Swillens
AU  - Sebastian Vermeersch
AU  - Dries Mahieu
AU  - Ernst Rietzschel
AU  - Marc De Buyzere
AU  - Luc Van Bortel
PY  - 2009
DA  - 2009/03/19
TI  - Limitations and pitfalls of non-invasive measurement of arterial pressure wave reflections and pulse wave velocity
JO  - Artery Research
SP  - 79
EP  - 88
VL  - 3
IS  - 2
SN  - 1876-4401
UR  - https://doi.org/10.1016/j.artres.2009.02.006
DO  - 10.1016/j.artres.2009.02.006
ID  - Segers2009
ER  -

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