Validity and Reliability of Diastolic Pulse Contour Analysis (Windkessel Model) in Humans

DOI Web Site 被引用文献3件
  • Timothy S. Manning
    From the Division of Clinical Pharmacology, Department of Medicine, State University of New York at Buffalo (T.S.M., J.L.I.), NY; and Biomedical Research Department, Navy Experimental Diving Unit, Naval Sea Systems Command (B.E.S.), Panama City, Fla.
  • Barbara E. Shykoff
    From the Division of Clinical Pharmacology, Department of Medicine, State University of New York at Buffalo (T.S.M., J.L.I.), NY; and Biomedical Research Department, Navy Experimental Diving Unit, Naval Sea Systems Command (B.E.S.), Panama City, Fla.
  • Joseph L. Izzo
    From the Division of Clinical Pharmacology, Department of Medicine, State University of New York at Buffalo (T.S.M., J.L.I.), NY; and Biomedical Research Department, Navy Experimental Diving Unit, Naval Sea Systems Command (B.E.S.), Panama City, Fla.

抄録

<jats:p> The present study assessed (1) the impact of the measurement site (lower versus upper extremity) on the corresponding compliance variables and (2) the overall reliability of diastolic pulse contour (Windkessel-derived) analysis in normal and hypertensive subjects. Arterial tonograms were recorded in the supine position from the radial and posterior tibial arteries in 20 normotensive (116±12/68±8 mm Hg) and 27 essential hypertensive subjects (160±16/94±14 mm Hg). Ensemble-averaged data for each subject were fitted to a first-order lumped-parameter model (basic Windkessel) to compute whole-body arterial compliance (C <jats:sub>A</jats:sub> ) and to a third-order lumped-parameter model (modified Windkessel) to compute proximal compliance (C <jats:sub>1</jats:sub> ) and distal compliance (C <jats:sub>2</jats:sub> ). Despite high-fidelity waveforms in each subject, the first-order Windkessel model did not yield interpretable (positive) values for C <jats:sub>A</jats:sub> in 50% of normotensives and 41% of hypertensives, whereas the third-order model failed to yield interpretable C <jats:sub>1</jats:sub> or C <jats:sub>2</jats:sub> results in 15% of normotensives and 41% of hypertensives. No between-site correlations were found for the first-order time constant, 2 of the 3 third-order model curve-fitting constants, or C <jats:sub>A</jats:sub> , C <jats:sub>1</jats:sub> , or C <jats:sub>2</jats:sub> ( <jats:italic>P</jats:italic> >0.50). Mean values for all 3 compliance variables were higher for the leg than the arm ( <jats:italic>P</jats:italic> <0.05 each). We conclude that differences in Windkessel-derived compliance values in the arm and leg invalidate whole-body model assumptions and suggest a strong influence of regional circulatory properties. The validity and utility of Windkessel-derived variables is further diminished by the absence of between-site correlations and the common occurrence of uninterpretable values in hypertensive subjects. </jats:p>

収録刊行物

  • Hypertension

    Hypertension 39 (5), 963-968, 2002-05

    Ovid Technologies (Wolters Kluwer Health)

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