Role of tapering in aortic wave reflection: hydraulic and mathematical model study

Pressure and flow have been measured simultaneously at six locations along the aorta of an anatomically correct 1:1 scale hydraulic elastic tube model of the arterial tree. Our results suggest a discrete reflection point at t he level of the renal arteries based on (i) the quarter-wavelength formula and (ii) the comparison of foot-to-foot (c(ff)) and apparent phase velocity (c(app)). However, separation of the pressure wave into an incident and re flected wave at all six locations indicates continuous reflection: a reflec ted wave is generated at each location as the forward wave passes by. We di d a further analysis using a mathematical transmission line model with a si mple tapering geometry (length 50 cm, 31 and 11 mm proximal and distal diam eter, respectively) for a low (0.32 ml/mmHg), normal (1.6 ml/mmHg) and high (8 ml/mmHg) value of total arterial compliance. Using the quarter-waveleng th formula, a discrete reflection point is found at x = 33 cm, the level of the renal arteries, independent of the value of total compliance. However. local analysis comparing c(ff) and c(app) does not reveal a marked reflect ion site, and the analysis of incident and reflected waves merely suggests a continuous reflection. We therefore conclude that the measured in vivo ao rtic wave reflection indices are the result of at least two interacting phe nomena. a continuous wave reflection due to tapering, and local reflections arising from branches at the level of the diaphragm. The continuous reflec tion is hidden in the input impedance pattern. Using the quarter-wavelength formula or the classical wave separation theory, it appears as a reflectio n coming from a single discrete site, confusingly also located at the level of the diaphragm, Therefore, the quarter-wavelength formula and the linear wave separation theory should be used with caution to identify wave reflec tion zones in the presence of tapering, i.e., in most mammalian arteries, ( C) 2000 Elsevier Science Ltd. All rights reserved.