Computational modeling demonstrates that secondary oscillations in the brachial pulse originate from lower body reflections, which has implications for interpreting blood pressure during vasodilator therapy.
The asymmetric T model for the arterial system is helpful to explain the major features of the aortic pulse but is not directly applicable to the peripheral pulse in the human upper limb. To explein changes in the transmitted central pulse a multibranched model was used to investigate retrograde wave transmission, concentrating on reflected waves from the lower body effective reflecting site as determined from the T tube model. Results indicate that secondary oscillations observed in the brachial pulse originate from reflections in the lower body, and not from local reflection phenomena. This has particular relevance in vasodilator therapy since lower body reflection contributes to increased peak pressure in the central pulse but Cot necessarily so in the brachial artery, where blood pressure is usually recorded.
Karamanoglu et al. (Wed,) studied this question.