Validity and Reliability of Diastolic Pulse Contour Analysis (Windkessel Model) in Humans
作者:
Timothy Manning,
Barbara Shykoff,
Joseph Izzo,
期刊:
Hypertension: Journal of The American Heart Association
(OVID Available online 2002)
卷期:
Volume 39,
issue 5
页码: 963-968
ISSN:0194-911X
年代: 2002
出版商: OVID
关键词: diastole;compliance;models, statistical;plethysmography;hemodynamics
数据来源: OVID
摘要:
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 (CA) and to a third-order lumped-parameter model (modified Windkessel) to compute proximal compliance (C1) and distal compliance (C2). Despite high-fidelity waveforms in each subject, the first-order Windkessel model did not yield interpretable (positive) values for CAin 50% of normotensives and 41% of hypertensives, whereas the third-order model failed to yield interpretable C1or C2results 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 CA, C1, or C2(P>0.50). Mean values for all 3 compliance variables were higher for the leg than the arm (P<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.
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