Wang Jiun-Jr, O'Brien Aoife B, Shrive Nigel G, Parker Kim H, Tyberg John V
Department of Medicine, University of Calgary, Calgary, Alberta, Canada T2N 4N1.
Am J Physiol Heart Circ Physiol. 2003 Apr;284(4):H1358-68. doi: 10.1152/ajpheart.00175.2002. Epub 2002 Dec 12.
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.
中心主动脉压(P(Ao))与血流波形在形态上的差异从未得到令人满意的解释,因为假定的解释(舒张期大量反射波)仍存在争议。作为被广泛接受的动脉血流动力学频域模型的替代方案,我们提出了一种功能性的时域动脉模型,该模型结合了血液传导系统和一个储液器(即弗兰克液压积分器,风箱)。在15只麻醉犬中,我们测量了P(Ao)、血流和尺寸,并计算了风箱压力(P(Wk))和容积(V(Wk))。我们发现P(Wk)与胸主动脉容积成正比,且胸主动脉容积占总V(Wk)的45.1±2.0%(平均值±标准误)。当我们从P(Ao)中减去P(Wk)时,发现差值(超压)与主动脉血流成正比,从而解决了P(Ao)与血流波形之间的差异,并表明反射波极小。我们认为在这个动物模型中,P(Ao)是时变储液器压力(即P(Wk))与(主要是)前行波效应的瞬时总和。