What is the clinical evidence from this study?

Population: Pulse wave reflection in the ascending aorta (n=7). Intervention: Aortic and carotid occlusion. Primary outcome: Timing of secondary pressure rises after initial pressure rise.

What question did this study set out to answer?

To determine how pulse wave reflections contribute to blood pressure and flow patterns in the ascending aorta under conditions of localized aortic and carotid artery occlusion.

September 1, 1976Cardiovascular Research

Reflection in the systemic arterial system: effects of aortic and carotid occlusion

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Key result

Aortic occlusion at different sites caused secondary pressure rises at times approximating the pulse travel time to the occlusion and back (e.g., 45 +/- 9.0 ms for high aortic occlusion).

Key Points

To determine how pulse wave reflections contribute to blood pressure and flow patterns in the ascending aorta under conditions of localized aortic and carotid artery occlusion.
Studied 7 closed-chest anesthetized male dogs instrumented with an ascending aorta electromagnetic flow transducer and an ascending aorta tip manometer.
Induced temporary occlusions at three descending aortic sites (high aorta, diaphragm level, renal artery level) using a femoral balloon catheter and performed bilateral carotid occlusions.
Calculated forward and reflected pressure and flow waves using reflection coefficients to evaluate wave summation.
Aortic occlusion produced secondary systolic pressure rises at 45 ± 9.0 ms (high occlusion), 75 ± 8.5 ms (diaphragm level), and 114 ± 16.5 ms (renal level) after the initial rise, matching pulse round-trip transit times.
Recorded waveforms resulted from the direct summation of forward and backward waves, with backward waves driving the secondary pressure rise and biphasic flow deceleration.
Bilateral carotid occlusion increased reflected wave amplitude across distributed reflection sites due to increased peripheral resistance rather than creating a single discrete reflection point.

Structured PICO

Population

7 closed-chest anaesthetized male dogs

Intervention

Aortic occlusions at three different sites (high aortic, diaphragm level, renal arteries level) and occlusion of both carotid arteries

Outcome

Pattern of flow and pressure in the ascending aorta (pulse wave reflection, secondary systolic rises, flow pulses)surrogate

Aortic occlusion at various sites in dogs demonstrates that secondary pressure rises and flow deceleration in the ascending aorta are caused by the summation of forward and backward reflected waves.

Discussion

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Implication

Extends wave reflection evidence from canine aortic occlusion; leaves open translation to human hemodynamics and practice.

Cite This Study

Bos et al. (1976) studied Pulse wave reflection in the ascending aorta (n=7). Aortic and carotid occlusion was evaluated on Timing of secondary pressure rises after initial pressure rise. Aortic occlusion at different sites caused secondary pressure rises at times approximating the pulse travel time to the occlusion and back (e.g., 45 +/- 9.0 ms for high aortic occlusion).

synapsesocial.com/papers/6a0db6b3cecdf5fb20ba9379 https://doi.org/10.1093/cvr/10.5.565

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Reflection in the systemic arterial system: effects of aortic and carotid occlusion

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Reflection in the systemic arterial system: effects of aortic and carotid occlusion

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Also Consider

Also Consider