Abstract
In this chapter, the changes that occur with aging in central aortic hemodynamics are discussed. With each contraction of the heart, a forward pressure and flow wave are generated, which travel down the arterial tree, giving rise to reflections and complex dynamic interaction with the distensible vessels. We first discuss cardiac contraction and heart–vessel interaction, considering both the ventricular–arterial elastance matching framework and recent insights based on time domain interpretation of ventricular–vascular coupling. Second, the current knowledge on the evolution of wave reflection with aging is presented, which summarizes impedance and wave separation analysis and relates this to integrative markers of wave reflection such as the augmentation index. Finally, age-related changes of central arterial pressure are discussed, and both carotid applanation tonometry and mathematical transformation of radial/brachial artery signals into a central pressure wave are considered.
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