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Effects of hydrostatic gradient on pressure and flow waveforms: understanding the complexity of the pressure-flow relationship. Hands up if you got it!

Journal of Human Hypertension volume 34, pages 474–475 (2020)Cite this article

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The pressure-flow relationship within each arterial segment has fascinated researchers for years. Rhythmic contractions and relaxations of the left ventricle generate pressure oscillations which, in turn, influence the flow waveform at any level of the arterial tree. The major determinant of the pressure-flow relationship is a physical property named arterial characteristic impedance, which is directly related to elastic modulus, arterial pressure, and wall thickness, and inversely related to lumen radius [1]. In a ideal sense, when transmural pressure equals to zero, characteristic impedance assumes its minimum value. Similarly, at any given level of the arterial tree, a higher characteristic impedance corresponds to a dampened flow wave irrespective of mean values of pressure and flow.

The concept of arterial characteristic impedance is well described when pressure and flow waves are decomposed in the frequency domain, as the average ratio between pressure and flow modulus at higher harmonics [2]. However, how dynamic changes in characteristic impedance could influence pulsatile pressure and flow transmission in the time domain, is more difficult to depict visually. In such a case, it is simpler to represent the pressure waveform as a sequence of successive wavefronts generating pressure increases during compression and pressure decreases during expansion. Each pressure increase accelerates blood flow velocity, whereas each pressure decrease generates flow decelerations. Wave intensity analysis is a way to represent this concept as the ratio of changes in pressure and flow velocities [3].

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Authors and Affiliations

  1. Department of Medicine, University of Perugia, Perugia, Italy

    Giacomo Pucci & Gaetano Vaudo

  2. Unit of Internal Medicine, Terni University Hospital, Terni, Italy

    Giacomo Pucci & Gaetano Vaudo

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  1. Giacomo Pucci
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  2. Gaetano Vaudo
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Correspondence to Giacomo Pucci.

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Pucci, G., Vaudo, G. Effects of hydrostatic gradient on pressure and flow waveforms: understanding the complexity of the pressure-flow relationship. Hands up if you got it!. J Hum Hypertens 34, 474–475 (2020). https://doi.org/10.1038/s41371-019-0236-5

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  • DOI: https://doi.org/10.1038/s41371-019-0236-5

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