Document Detail

Pulse pressure amplification, arterial stiffness, and peripheral wave reflection determine pulsatile flow waveform of the femoral artery.
MedLine Citation:
PMID:  20876451     Owner:  NLM     Status:  MEDLINE    
Aortic stiffness, peripheral wave reflection, and aorta-to-peripheral pulse pressure amplification all predict cardiovascular risk. However, the pathophysiological mechanism behind it is unknown. Tonometric pressure waveforms were recorded on the radial, carotid, and femoral arteries in 138 hypertensive patients (age: 56±13 years) to estimate aorta-to-peripheral amplifications, aortic augmentation index, and aortic (carotid-femoral) pulse wave velocity. The femoral Doppler velocity waveform was recorded to calculate the reverse/forward flow index and diastolic/systolic forward flow ratio. The aorta-to-femoral and aorta-to-radial amplifications correlated inversely with the aortic augmentation index and pulse wave velocity. The femoral flow waveform was triphasic, composed of systolic forward, subsequent reverse, and diastolic forward phases in 129 patients, whereas it was biphasic and lacked a diastolic forward flow in 9 patients. Both the femoral reverse index (30±10%) and diastolic forward ratio (12±4%) correlated positively with the aorta-to-femoral amplification and inversely with the aortic augmentation index and pulse wave velocity; these correlations were independent of age, sex, diastolic pressure, and femoral artery diameter. Patients with biphasic (versus triphasic) flow were older, shorter, included more diabetics, had smaller femoral diameters, and showed greater aortic pulse wave velocity even when adjusted for all of these covariates. In conclusion, because of the inverse (peripheral-to-aortic) pressure gradient, pulse pressure amplification normally produces a substantial reversal of the femoral flow, the degree of which is determined by the aortic distensibility and peripheral wave reflection. Arteriosclerosis (increased stiffness, increased augmentation, and reduced amplification) decreases both the reverse and diastolic forward flows, potentially causing circulatory disturbance of truncal organs and lower extremities.
Junichiro Hashimoto; Sadayoshi Ito
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-09-27
Journal Detail:
Title:  Hypertension     Volume:  56     ISSN:  1524-4563     ISO Abbreviation:  Hypertension     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-10-21     Completed Date:  2010-11-10     Revised Date:  2011-03-21    
Medline Journal Info:
Nlm Unique ID:  7906255     Medline TA:  Hypertension     Country:  United States    
Other Details:
Languages:  eng     Pagination:  926-33     Citation Subset:  IM    
Department of Blood Pressure Research, Tohoku University Graduate School of Medicine, Sendai, Japan.
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MeSH Terms
Analysis of Variance
Blood Flow Velocity / physiology*
Blood Pressure / physiology*
Femoral Artery / physiopathology*,  ultrasonography
Hypertension / physiopathology*,  ultrasonography
Middle Aged
Pulsatile Flow / physiology*
Regression Analysis
Vascular Resistance / physiology*
Comment In:
Hypertension. 2011 Mar;57(3):e11; author reply e12   [PMID:  21220712 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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