P6.21 EFFECTS OF PHARMACOLOGICAL DRUGS ON THE AORTIC PRESSURE PULSE: UNDERSTANDING MECHANISMS THROUGH MODELLING

DOI

10.1016/j.artres.2013.10.202How to use a DOI?

Abstract

Aortic pulse pressure and other pulsatile components of the aortic pressure pulse are important predictors of cardiovascular outcomes, however the properties of the arterial tree that determine the aortic pulse are still poorly understood. We used numerical modelling to predict aortic pulse morphology and the characteristics of the arterial tree that determine pulse wave morphology when modulated by pharmacological agents with differential actions on the myocardium and arterial tree. Healthy volunteers aged 35 to 63 received cumulative doses of nitroglycerin (NTG, n=8), dobutamine (DB, n=10) and nor-epinephrine (NE, n=9). Aortic pressure was measured by carotid tonometry. Aortic dimensions, pulse wave velocity (PWV), blood velocity and flow were measured by echocardiography. These parameters were used to calculate the input data of a single-vessel, nonlinear one-dimensional model of pulse wave propagation in the human aorta coupled to a three-element Windkessel model of the downstream vasculature. The simulated pressure waveforms relative to the clinical data were reproduced with a averaged normalised root-mean-square-error < 10%, 7% and 6% for DB, NE and NTG groups respectively. By systematically and uniquely changing the parameters of the model by the amount measured clinically whilst keeping all other parameters at baseline conditions we identified the most significant determinant of the final pressure waveform to be total compliance and PWV for DB and peripheral vascular resistance for NTG and NE. Thus the majority of the change in aortic pulse morphology can be explained without invoking a change in the distributed characteristics of the arterial tree.

Open Access

This is an open access article distributed under the CC BY-NC license.

TY  - JOUR
AU  - S. Epstein
AU  - H. Fok
AU  - P. Chowienczyk
AU  - J. Alastruey-Arimon
PY  - 2013
DA  - 2013/11/11
TI  - P6.21 EFFECTS OF PHARMACOLOGICAL DRUGS ON THE AORTIC PRESSURE PULSE: UNDERSTANDING MECHANISMS THROUGH MODELLING
JO  - Artery Research
SP  - 159
EP  - 160
VL  - 7
IS  - 3-4
SN  - 1876-4401
UR  - https://doi.org/10.1016/j.artres.2013.10.202
DO  - 10.1016/j.artres.2013.10.202
ID  - Epstein2013
ER  -