Time-domain representation of ventricular-arterial coupling as a windkessel and wave system.

The differences in shape between central aortic pressure (P(Ao)) and flow waveforms have never been explained satisfactorily in that the assumed explanation (substantial reflected waves during diastole) remains controversial. As an alternative to the widely accepted frequency-domain model of arterial hemodynamics, we propose a functional, time-domain, arterial model that combines a blood conducting system and a reservoir (i.e., Frank's hydraulic integrator, the windkessel). In 15 anesthetized dogs, we measured P(Ao), flows, and dimensions and calculated windkessel pressure (P(Wk)) and volume (V(Wk)). We found that P(Wk) is proportional to thoracic aortic volume and that the volume of the thoracic aorta comprises 45.1 +/- 2.0% (mean +/- SE) of the total V(Wk). When we subtracted P(Wk) from P(Ao), we found that the difference (excess pressure) was proportional to aortic flow, thus resolving the differences between P(Ao) and flow waveforms and implying that reflected waves were minimal. We suggest that P(Ao) is the instantaneous summation of a time-varying reservoir pressure (i.e., P(Wk)) and the effects of (primarily) forward-traveling waves in this animal model.

[1]  K. Parker,et al.  Negative wave reflections in pulmonary arteries. , 2001, American journal of physiology. Heart and circulatory physiology.

[2]  D. Burkhoff,et al.  Assessment of Windkessel as a model of aortic input impedance. , 1988, The American journal of physiology.

[3]  W. Laskey,et al.  Repeated reflection of waves in the systemic arterial system. , 1993, The American journal of physiology.

[4]  C R Thompson,et al.  The pulmonary venous systolic flow pulse--its origin and relationship to left atrial pressure. , 1999, Journal of the American College of Cardiology.

[5]  Y C Fung,et al.  The degree of nonlinearity and anisotropy of blood vessel elasticity. , 1997, Proceedings of the National Academy of Sciences of the United States of America.

[6]  A. Noordergraaf Circulatory System Dynamics , 1978 .

[7]  K Sagawa,et al.  Translation of Otto Frank's paper "Die Grundform des Arteriellen Pulses" Zeitschrift für Biologie 37: 483-526 (1899). , 1990, Journal of molecular and cellular cardiology.

[8]  O. Frank,et al.  Die grundform des arteriellen pulses , 1899 .

[9]  N. Westerhof,et al.  Aortic Input Impedance in Normal Man: Relationship to Pressure Wave Forms , 1980, Circulation.

[10]  D. A. Mcdonald Blood flow in arteries , 1974 .

[11]  A Noordergraaf,et al.  Analog studies of the human systemic arterial tree. , 1969, Journal of biomechanics.

[12]  N Westerhof,et al.  The arterial system characterised in the time domain. , 1980, Cardiovascular research.

[13]  P Segers,et al.  Use of pulse pressure method for estimating total arterial compliance in vivo , 1999 .

[14]  Y Lecarpentier,et al.  Pulmonary artery pulse pressure and wave reflection in chronic pulmonary thromboembolism and primary pulmonary hypertension. , 2001, Journal of the American College of Cardiology.

[15]  A P Avolio,et al.  Functional origin of reflected pressure waves in a multibranched model of the human arterial system. , 1994, The American journal of physiology.

[16]  Kim H. Parker,et al.  What stops the flow of blood from the heart? , 2005, Heart and Vessels.

[17]  N. Westerhof,et al.  Forward and backward waves in the arterial system. , 1972, Cardiovascular research.

[18]  A Noordergraaf,et al.  Constructive and destructive addition of forward and reflected arterial pulse waves. , 2001, American journal of physiology. Heart and circulatory physiology.

[19]  Abraham Noordergraaf,et al.  The Arterial Trees , 1978 .

[20]  S. Rowlands Is the arterial pulse a soliton? , 1982 .

[21]  S. Magder Starling resistor versus compliance. Which explains the zero-flow pressure of a dynamic arterial pressure-flow relation? , 1990, Circulation research.

[22]  K. Parker,et al.  Forward and backward running waves in the arteries: analysis using the method of characteristics. , 1990, Journal of biomechanical engineering.

[23]  N Westerhof,et al.  Evaluation of methods for estimation of total arterial compliance. , 1995, The American journal of physiology.

[24]  E. Skuza,et al.  Interactions between the right ventricle and pulmonary vasculature in the fetus. , 1999, Journal of applied physiology.

[25]  Swamy Laxminarayan,et al.  Characterization of the Arterial System in the Time Domain , 1978, IEEE Transactions on Biomedical Engineering.

[26]  John V. Tyberg,et al.  Control of the Circulation: An Integrated View , 1996 .

[27]  James Lighthill,et al.  Waves In Fluids , 1966 .

[28]  D H Fitchett LV-arterial coupling: interactive model to predict effect of wave reflections on LV energetics. , 1991, The American journal of physiology.

[29]  L. Chambers Linear and Nonlinear Waves , 2000, The Mathematical Gazette.

[30]  F. Yin,et al.  Estimating arterial resistance and compliance during transient conditions in humans. , 1989, The American journal of physiology.

[31]  Jiun Wang,et al.  Wave propagation in a model of the human arterial system , 1992 .

[32]  I. Belenkie,et al.  Ventricular interaction and venous capacitance modulate left ventricular preload. , 1996, The Canadian journal of cardiology.

[33]  C. Rothe,et al.  Vascular Capacitance and Fluid Shifts in Dogs during Prolonged Hemorrhagic Hypotension , 1976, Circulation research.

[34]  A. C. Burton On the physical equilibrium of small blood vessels. , 1951, The American journal of physiology.

[35]  J. Mcanulty,et al.  CARDIOVASCULAR PHYSIOLOGY , 1981, Clinical obstetrics and gynecology.

[36]  J. Womersley,et al.  Oscillatory Flow in Arteries. II: The Reflection of the Pulse Wave at Junctions and Rigid Inserts in the Arterial System , 1958, Physics in medicine and biology.

[37]  K. Parker,et al.  Wave-intensity analysis: a new approach to coronary hemodynamics. , 2000, Journal of applied physiology.

[38]  J. Womersley Oscillatory flow in arteries: the constrained elastic tube as a model of arterial flow and pulse transmission. , 1957, Physics in medicine and biology.

[39]  B. Westerhof,et al.  Physical basis of pressure transfer from periphery to aorta: a model-based study. , 1998, The American journal of physiology.