Transmural Arterial Pressure Research Articles

Microvascular development and remodeling

Skeletal fragility is an important complication of Type 1 Diabetes (T1D), particularly among older adults. Microvascular disease (MVD) has been linked to worse bone health in T1D, suggesting a potential direct pathophysiologic link between vascular disease and bone deficits. However, bone vascular control has not been explored in the context of T1D. Thus, this preliminary work investigates key mechanisms of regulation of the bone vasculature in older adults with T1D. Myogenic vasoconstriction and reactive hyperemia of tibial blood flow were assessed in older healthy adults (n=9, 65 ± 7 yrs) and older adults with T1D (n=10, 63 ± 6 yrs). Myogenic vasoconstriction was assessed in response to leg dependency (two levels of increased arterial transmural pressure obtained by lowering the leg below heart level) and reactive hyperemia was assessed in response to lower leg arterial occlusion via thigh cuff inflation. The initial peak reactive hyperemic response was considered a surrogate of myogenic vasodilation. For both stimuli, tibial blood flow was assessed via NIRS as total hemoglobin (tHb) and whole leg blood flow velocity (LBF) in the popliteal artery of the same leg was measured via Doppler ultrasound. Data are presented as mean±standard error. In response to leg dependency, with increased perfusion pressure, older adults had a tendency for smaller declines in LBF (L1: -3.85 ± 2.01 cm/s; L2: -6.22 ± 4.19 cm/s) compared to older adults with T1D (L1: -6.14 ±2.24 cm/s; L2: -10.4 ± 1.90 cm/s; group p=0.06, level p=0.07). Tibial tHb did not decline in older adults (L1: 1.16 ± 7.27 M; L2: 9.11 ± 13.8 M), but decreased progressively in those with T1D (L1: - 3.40 ± 2.79 M, L2: -6.14 ± 2.24 M, group p<0.01, group*level p=0.07), indicating pronounced tibial myogenic vasoconstriction. In response to reactive hyperemia, LBF increased rapidly with cuff release in both groups (older adults: 50.8 ±22.7cm/s; T1D: 40.0 ± 13.4cm/s). Despite similar responses in LBF, tibial tHb surpassed baseline values in older adults (1.50 ± 5.35M), whereas tibial tHb did not reach baseline values within 5 min post cuff release in T1D (-2.85 ± 5.09M, p=0.09), indicating impaired tibial myogenic vasodilation. Interestingly, older adults with T1D and MVD (n=5) had a stronger tendency for greater tibial myogenic vasoconstriction at both levels and significantly impaired reactive hyperemic response compared to those with no MVD (n=5). Our preliminary results indicate that older adults with T1D have greater myogenic vasoconstriction and impaired reactive hyperemic responses that appear to be worse in the presence of MVD. Alterations in myogenic control act to compromise blood flow regulation, restricting blood flow to bone, and potentially contributing to diabetes-inducted skeletal fragility. NIH NIDDK R01 DK124710. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Normalization of Flow-mediated Dilation to Brachial Artery Material Property: A Feasibility Study.

Endothelial reactivity (ER) is widely measured using flow-mediated dilation (FMD) of brachial artery. Conventional measurement of FMD is influenced by factors such as input shear stress, arterial transmural pressure, diameter and thereby arterial material properties (ε). Thus, for a reliable interpretation of FMD, it has to be normalized with respect to the above confounding factors. Normalization of FMD with shear stress at the time of measurement has been reported to reduce measurement variability. However, its widespread usage among the research community is limited. In this work, we examine the feasibility of normalizing the brachial FMD index (FMD%) to ε : extrema (εp), baseline (εb) and extrema change (∆ε) post-ischemia using its inter-day variability against FMD. In-vivo measurements were performed on 10 participants for 2 consecutive days and simultaneous pressure-diameter cycles were collected to estimate the material properties during reactive hyperemia (RH). The box-whisker plot reveals differences in the mean and deviation of FMD to FMD|εb. A significant value for repeatability (ICC ≥ 0.6) was obtained for normalized FMD (FMD|εb) for specific stiffness index (β), pressure-strain elastic modulus (Ep), and local pulse wave velocity (PWV) as compared to FMD. Hence, normalization of FMD% to arterial ε can potentially improve the measurement reliability of ER assessment.Clinical Relevance- This pilot study demonstrates the feasibility of brachial artery stiffness assessment during FMD and its potential use for normalizing the standard FMD measurement.

Arterial pulsation modulates the optical attenuation coefficient of skin.

Photoplethysmographic (PPG) signals arise from the modulation of light reflectivity on the skin due to changes of physiological origin. Imaging plethysmography (iPPG) is a video-based PPG method that can remotely monitor vital signs in a non-invasive manner. iPPG signals result from skin reflectivity modulation. The origin of such reflectivity modulation is still a subject of debate. Here, we have used optical coherence tomography (OCT) imaging to find whether iPPG signals may result from skin optical properties being directly or indirectly modulated by arterial transmural pressure propagation. The light intensity across the tissue was modeled through a simple exponential decay (Beer-Lambert law) to analyze in vivo the modulation of the optical attenuation coefficient of the skin by arterial pulsation. The OCT transversal images were acquired from a forearm of three subjects in a pilot study. The results show that the optical attenuation coefficient of skin changes at the same frequency as the arterial pulsation due to transmural pressure propagation (local ballistographic effect), but we cannot discard the contribution of global ballistographic effects.

Repeated Retching and Vomiting in the Pathophysiology of Isolated Spinal Aneurysms

Rupture of spinal aneurysms is a rare cause of subarachnoid hemorrhage. These aneurysms are often associated with a variety of vascular malformations that increase blood flow in the spinal circulation or with disorders that compromise the vessel wall. However, spinal aneurysms may be isolated, not associated with any known predisposing condition. The objective of this study is to explore the possible mechanisms associated with the formation and rupture of isolated spinal aneurysms (ISAs). We conducted a retrospective review of a series of consecutive patients admitted for a ruptured ISA. In all cases, spinal angiography confirmed the presence of a spinal aneurysm responsible for the bleeding. Particular attention was paid to medical history and symptoms before bleeding, for potential factors predisposing to their formation and rupture. Between 2008 and 2020, ten cases of spinal aneurysms were seen at our institution including 4 cases of ISA. All patients with ISA were female, and in 3 cases the aneurysm involved the territory of the posterior spinal artery. In 3 of these 4 (75%) ISA cases, there was a strikingly similar history of retching and vomiting preceding the thunderclap headache. In 1 patient, the aneurysm was surgically resected; pathologic analysis revealed a fusiform dissecting aneurysm. All 4 patients had a favorable outcome. We suggest that the straining during prolonged retching and vomiting plays a role in the formation and rupture of some ISAs, possibly because of pressure spikes, increased transmural arterial pressure, and increased wall shear stress during straining.

Arteries Stiffen With Age, but Can Retain an Ability to Become More Elastic With Applied External Cuff Pressure.

It is accepted that arterial compliance decreases with age, with changes in the arterial pulse shape measured at the periphery. The aim of this study was to determine the relationship between arterial transmural pressure changes and changes in peripheral finger pulse shape characteristics for both older and younger subjects.Finger photoplethysmographic pulses were recorded noninvasively from the right index fingers of 100 healthy normotensive subjects. Their median age was 43 years (range 20–71 years) allowing two distinct age groups to be compared (older group ≥45 and younger group < 45 years). Arterial transmural pressures on the whole right arm were reduced with a 50 cm long cuff inflated to 10, 20, 30, and 40 mmHg. Pulse maximum amplitude and rise time were calculated for each age group, and for each cuff pressure level.Gradual and significant decreases in both pulse maximum amplitude and rise time were found with increasing cuff pressure for both age groups. With an external cuff pressure of 40 mmHg, there was an average maximum amplitude and rise time decrease of 27.1% (P < 0.001) and 7.5% (P < 0.001) respectively. The changes in the older group were significantly greater than those in the younger group for maximum amplitude (30.3% vs 24.4%, P = 0.006), but not for rise time (8.0% vs 6.7%, P = 0.23).Our results show that arterial compliance of the arm artery increases with reduced transmural pressure for both older and younger groups, and demonstrate that the aged arm artery can become more elastic with applied external cuff pressure.

A pilot application of Korotkoff sound delay time in evaluating cardiovascular status.

Korotkoff sounds have been used to measure systolic and diastolic arterial blood pressures noninvasively for over 100 years. However, most of the research concerning the Korotkoff sound were focused on the origin and frequency component analyzing the Korotkoff sound signal. To show that the occurrence time of the Korotkoff sounds for each cardiac cycle demonstrates a characteristic value during the cuff deflating process of blood pressure measurement. The Korotkoff sound delay time (KDT) decreases as the cuff pressure P deflates and KDT is a function of arterial transmural pressure. In the present research, an experiment system was established to explore the relationship between the KDT and the cuff pressure in different subjects. A pilot experiment was conducted to obtain different subjects' KDTs and investigate the relationship between KDT and cuff pressure. The relationship between KDT and invasive blood pressure was also studied and its potential application in detection of cardiovascular status was discussed.

A new look at the essence of the imaging photoplethysmography.

Photoplethysmography (PPG) is a noninvasive optical method accepted in the clinical use for measurements of arterial oxygen saturation. It is widely believed that the light intensity after interaction with the biological tissue in vivo is modulated at the heartbeat frequency mainly due to pulsatile variations of the light absorption caused by arterial blood-volume pulsations. Here we report experimental observations, which are not consistent with this model and demonstrate the importance of elastic deformations of the capillary bed in the formation of the PPG waveform. These results provide new insight on light interaction with live tissue. To explain the observations we propose a new model of PPG in which pulse oscillations of the arterial transmural pressure deform the connective-tissue components of the dermis resulting in periodical changes of both the light scattering and absorption. These local changes of the light-interaction parameters are detected as variations of the light intensity returned to a photosensitive camera. Therefore, arterial pulsations can be indirectly monitored even by using the light, which slightly penetrates into the biological tissue.

Photoplethysmographic Waveform as a Function of Subject's Age

In this report we present the experimental study of imaging photoplethysmography in the area of the palm and wrist of fifty-six healthy subjects. We found that the amplitude of the PPG waveform is unevenly distributed over the studied area forming the hot spots with the elevated amplitude. There is clear tendency of the amplitude increasing in the hottest spots with the age of the subject. These observations support the recently proposed model of photoplethysmography in which pulse oscillations of the arterial transmural pressure deform the connective-tissue components of the dermis resulting in periodical changes of both the light scattering and absorption.

The vibration plethysmographic method of arterial compliance analysis in dependence on transmural pressure.

The aim of this study was to obtain a detailed analysis of the relationship between the finger arterial compliance C [ml/mm Hg] and the arterial transmural pressure P(t) [mm Hg]. We constructed a dynamic plethysmograph enabling us to set up a constant pressure P(css) [mm Hg] and a superimposed fast pressure vibration in the finger cuff (equipped with a source of infra-red light and a photoelectric sensor for the measurement of arterial volume). P(css) could be set on the required time interval in steps ranging between 30 and 170 mm Hg, and on sinusoidal pressure oscillation with an amplitude P(ca) (2 mm Hg) and a frequency f (20, 25, 30, 35, 40 Hz). At the same time continuous blood pressure BP was measured on the adjacent finger (Portapres). We described the volume dependence of a unitary arterial length on the time-varying transmural pressure acting on the arterial wall (externally P(css)+P(ca).sin(2pif), internally BP) by a second-order differential equation for volume. This equation was linearized within a small range of selected BP. In the next step, a Fourier transform was applied to obtain the frequency characteristic in analytic form of a complex linear combination of frequency functions. While series of oscillations [P(ca), f] were applied for each P(css), the corresponding response of the plethysmogram was measured. Amplitude spectra were obtained to estimate coefficients of the frequency characteristic by regression analysis. We determined the absolute value: elastance E, and its inverse value: compliance (C=1/E). Then, C=C(P(t)) was acquired by applying sequences of oscillations for different P(css) (and thus P(t)) by the above-described procedure. This methodology will be used for the study of finger arterial compliance in different physiological and pathological conditions.

Cardiovascular design in fin whales: high-stiffness arteries protect against adverse pressure gradients at depth

Fin whales have an incompliant aorta, which, we hypothesize, represents an adaptation to large, depth-induced variations in arterial transmural pressures. We hypothesize these variations arise from a limited ability of tissues to respond to rapid changes in ambient ocean pressures during a dive. We tested this hypothesis by measuring arterial mechanics experimentally and modelling arterial transmural pressures mathematically. The mechanical properties of mammalian arteries reflect the physiological loads they experience, so we examined a wide range of fin whale arteries. All arteries had abundant adventitial collagen that was usually recruited at very low stretches and inflation pressures (2-3 kPa), making arterial diameter largely independent of transmural pressure. Arteries withstood significant negative transmural pressures (-7 to -50 kPa) before collapsing. Collapse was resisted by recruitment of adventitial collagen at very low stretches. These findings are compatible with the hypothesis of depth-induced variation of arterial transmural pressure. Because transmural pressures depend on thoracic pressures, we modelled the thorax of a diving fin whale to assess the likelihood of significant variation in transmural pressures. The model predicted that deformation of the thorax body wall and diaphragm could not always equalize thoracic and ambient pressures because of asymmetrical conditions on dive descent and ascent. Redistribution of blood could partially compensate for asymmetrical conditions, but inertial and viscoelastic lag necessarily limits tissue response rates. Without pressure equilibrium, particularly when ambient pressures change rapidly, internal pressure gradients will develop and expose arteries to transient pressure fluctuations, but with minimal hemodynamic consequence due to their low compliance.

Noninvasive measurement of beat-to-beat arterial blood pressure by the Korotkoff sound delay time

To propose a novel noninvasive beat-to-beat arterial blood pressure measurement method based on the Korotkoff sound delay time (KDT) and evaluate its accuracy in preliminary experiments. KDT decreases as the cuff pressure P deflates, which can be described by a function KDT=f (P). Actually, KDT is a function of arterial transmural pressure. Therefore, the variation in blood pressure can be obtained by the transmural pressure, which is estimated by the KDT. Holding the cuff pressure at an approximate constant pressure between systolic pressure and diastolic pressure, the variation in blood pressure ΔEBP between successive heartbeats can be estimated according to KDT and f'(p), which represents the variation of KDT corresponding to unit pressure. Then the blood pressure for each heartbeat can be obtained by accumulating the ΔEBP. Invasive and noninvasive blood pressure values of six participants were measured simultaneously to evaluate the method. The average of the correlation coefficients between the invasive mean arterial pressure (MAP) and the KDT for six participants was -0.91. The average of the correlation coefficients between the invasive MAP and the estimated mean blood pressure (EBP) was 0.92. The mean difference between EBP and MAP was 0.51 mmHg, and the SD was 2.65 mmHg. The mean blood pressure estimated by the KDT is consistent with the invasive MAP. The beat-to-beat blood pressure estimated by KDT provides an accurate estimate of MAP in the preliminary experiments and represents a potential acceptable alternative to invasive blood pressure monitoring during laboratory studies.

Peripheral arterial volume distensibility: significant differences with age and blood pressure measured using an applied external pressure

A new arterial distensibility measurement technique was assessed in 100 healthy normotensive subjects. Arterial transmural pressures on the whole right arm were reduced with a 50 cm long cuff inflated to 10, 20, 30 and 40 mmHg. The electrocardiogram, and finger and ear photoplethysmograms were recorded simultaneously. Arm pulse propagation time, pulse wave velocity (PWV) and arterial volume distensibility were determined. With a 40 mmHg reduction in transmural pressure, arm pulse propagation time increased from 61 to 83 ms, PWV decreased from 12 to 8 m s−1 and arterial distensibility increased from 0.102% to 0.232% per mmHg (all P < 0.0001). At all cuff pressures, arterial distensibility was significantly related to resting mean arterial pressure (MAP), diastolic blood pressure (DBP) and age, and for systolic blood pressure at 30 and 40 mmHg (all P < 0.05). At 40 mmHg cuff pressure, arterial distensibility fell by 54% for a MAP increase from 75 to 105 mmHg, 57% for a DBP increase from 60 to 90 mmHg and 47% for an age increase from 20 to 70 years. These changes were more than double than those without cuff pressure. Our technique showed that systemic volume distensibility of the peripheral arm artery reduced with age, with a greater effect at higher external and lower transmural pressures.

The effect of prolonged endurance exercise upon blood pressure regulation during a postexercise orthostatic challenge

ObjectiveTo investigate the regulation of blood pressure in response to an orthostatic challenge in athletes running a marathon.Methods10 experienced male runners (mean (SD) age 29 (4) years) were tested on...

Contribution of collagen, elastin, and smooth muscle to in vivo human brachial artery wall stress and elastic modulus.

The contributions of collagen, elastin, and smooth muscle to arterial mechanical properties in the in vivo human artery are not known. We used a recently developed intravascular ultrasound technique to measure total brachial artery wall stress and incremental elastic modulus (Einc) in seven normal human subjects at baseline and after intra-arterial norepinephrine (1.2 micrograms) and nitroglycerin (100 micrograms). Then we applied a modified Maxwell model to estimate the elastic modulus of elastin (EE); the recruitment of collagen fibers supporting wall stress; and the differential contributions of collagen, elastin, and smooth muscle to wall stress and Einc over a wide range of pressure and smooth muscle tone. With this model, EE was 3 x 10(6) dynes/cm2. Collagen fibers were recruited increasingly as transmural arterial pressure increased and reached a value of approximately 5% to 6% at 100 mm Hg under each of the conditions studied. Isobaric smooth muscle contraction resulted in a small decrease in total wall stress and no significant change in total Einc while shifting the predominant element contributing to these mechanical parameters from collagen in parallel with the smooth muscle to collagen in series with the smooth muscle. In contrast, isometric smooth muscle contraction produced large increases in total wall stress (from 0.11 x 10(6) dynes/cm2 after nitroglycerin administration to 1.35 x 10(6) dynes/cm2 after norepinephrine administration) and Einc (from 3.84 x 10(6) dynes/cm2 after nitroglycerin administration to 57.8 x 10(6) dynes/cm2 after norepinephrine administration) entirely as a result of the additional contribution of the smooth muscle and its associated series collagen. This study describes a technique for determining arterial elastic properties and a model that can be used to estimate a number of mechanical parameters of the human brachial artery in vivo. This technique may be useful in studies of the arterial elastic properties of arteries in patients with vascular pathology.

Autoregulation during pressor response elevates wall shear rate in arterioles.

Autoregulation of blood flow implies reciprocal changes in vessel diameter and red blood cell velocity (VRBC) when perfusion pressure is altered. We tested two hypotheses: 1) blood flow will be autoregulated throughout arteriolar networks during a pressor response, and 2) wall shear rate (WSR; proportional to VRBC/diameter) will increase during autoregulation. Male hamsters (109 +/- 3 g; n = 22) were anesthetized (pentobarbital sodium 60 mg/kg), and the cremaster muscle was prepared for intravital videomicroscopy. Internal diameter and VRBC were monitored in first (1A)- through fourth (4A)-order arterioles; WSR and blood flow were calculated. Data were acquired at rest and at the peak of diameter responses to bilateral carotid artery occlusion (CAO). At rest, 1) mean arterial and 1A transmural pressures were 100 +/- 5 and 59 +/- 4 mmHg, respectively; 2) as branch order increased, arteriolar diameter, VRBC, and blood flow decreased (P < 0.05); and 3) WSR and resting tone increased with branch order (P < 0.05). During pressor responses to CAO, 1) arterial and 1A pressures increased to 145 +/- 7 and 89 +/- 5 mmHg, respectively (P < 0.05); 2) 1A branches dilated while 2A, 3A, and 4A branches constricted (P < 0.05); 3) VRBC and WSR increased in all branches (P<0.05); and 4) blood flow increased in 1A and 2A branches (P < 0.05), yet was unchanged (i.e., was autoregulated) in 3A and 4A branches. Arteriolar constrictions during CAO were not affected by alpha-adrenoceptor blockade with phentolamine (10(-6) M). We conclude that autoregulation of muscle blood flow during a pressor response involves myogenic constriction of arterioles with concomitant elevation of WSR.

Estimation of blood pressure-related parameters by electrical impedance measurement.

In 13 healthy volunteers a computerized experimental set-up was used to measure the electrical impedance of the upper arm at changing cuff pressure, together with the finger arterial blood pressure in the contralateral arm. On the basis of a model for the admittance response, the arterial blood volume per centimeter length (1.4 +/- 0.3 ml/cm), the venous blood volume as a percentage of the total blood compartment (49.2 +/- 12.6%), and the total arterial compliance as a function of mean arterial transmural pressure were estimated. The effective physiological arterial compliance amounted to 2.0 +/- 1.3 microliters.mmHg-1.cm-1 and the maximum compliance to 33.4 +/- 12.0 microliters.mmHg-1.cm-1. Additionally, the extravascular fluid volume expelled by the occluding cuff (0.3 +/- 0.3 ml/cm) was estimated. These quantities are closely related to patient-dependent sources of an unreliable blood pressure measurement and vary with changes in cardiovascular function, such as those found in hypertension. Traditionally, a combination of several methods is needed to estimate them. Such methods, however, usually neglect the contribution of extravascular factors.

Physical fitness, dynamic extra-arterial pressures, and the pathogenesis and distribution of atherosclerosis

Medical writings on cardiovascular disease focus on intravascular pressures. Tissue pressure is assurned to be essentially atmospheric. Yet, under dynamic conditions of sitting, standing, walking, breathing, and the beating of the heart, significant pressures, both above and below atmospheric, do develop outside of important arteries. These dynamic extra-arterial pressures either decrease or increase the pressure gradients across arterial walls, i.e. the transmural pressures are changed. Physical fitness may either prevent the development of negative extra-arterial pressure or increase positive extra-arterial pressure, thereby protecting important arteries from high effective pressures. Deconditioning, old age, abdominal obesity, and other cardiovascular disease risk factors may do just the opposite, in effect, causing ‘localized hypertension’ in clinically important arteries. This, in turn, may lead to localized acceleration of atherosclerosis. The correlation of predictions made from this hypothesis with clinical findings is so remarkable that it suggests there is a direct cause and effect relationship between transmural arterial pressure and atherosclerosis. The concept of dynamic extra-arterial pressure seems to solve a number of puzzles and paradoxes in cardiovascular disease, it suggests key measurements that may be predictive of disease, and it offers new ideas for treatment and prevention.

Cerebrovascular response to changes of cerebral venous pressure and cerebrospinal fluid pressure

Using parietal cranial windows and multichannel videoangiometry, pial vessel responses were studied in cats during stepwise elevation of superior sagittal sinus pressure (Psss) to a level of 50 mmHg or reduction of CSF-pressure (PCSF). PCSF was monitored via a needle in the great cistern, known from previous studies to be identical to supratentorial CSF-pressure. During elevation of PSSS, large and small pial veins dilated by 14 +/- 6.1% from resting diameter. Small arteries remained unresponsive until they were dilated by 9 +/- 2.1% at the level of PSSS 50 mmHg. Large arteries dilated by 18 +/- 5.5% at the level of PSSS 50 mmHg. PSSS was always approximately twice as high as PCSF during increase of PSSS. During reduction of PCSF to -5 mmHg, pial veins also dilated, by 7.4 +/- 1% on the average. This observation suggests that normal PCSF is a result of mainly venous vascular pressure, and that the level of normal venous pressure is not dictated by PCSF but by the function and architecture of the cerebral vasculature. Since the rapid reduction of cerebral perfusion pressure CPP by elevation of venous pressure does not induce autoregulatory adjustment according to the level of CPP, but to the level of arterial transmural pressure, it is concluded, that the basic mechanism underlying autoregulation of CBF is myogenic.

Mechanisms of pulsus paradoxus in airway obstruction

To assess the mechanisms of pulsus paradoxus (i.e., inspiratory decline of greater than or equal to 10 Torr in systolic pressure) in airway obstruction, we studied 12 patients with chronic airflow obstruction before and during breathing through an external resistance that provided loads during both inspiration and expiration. Esophageal pressure (Ppl) and brachial artery pressure, relative to either atmospheric (Pa) or esophageal pressure (Patm), were measured simultaneously during normal and loaded breathing. It was assumed that changes in intrathoracic systemic arterial transmural pressure were adequately represented by Patm. During control, no significant difference between systolic fluctuation (delta Pa) and pleural swings (delta Ppl) was found. Concurrently, inspiratory and expiratory Patm were nearly identical. By contrast, under maximally loaded conditions, higher magnitudes of delta Ppl than delta Pa were found and consequently Patm rose with inspiration. In this connection, the plot of delta Pa against delta Ppl showed that the slopes for delta Ppl less than or equal to 15 Torr (1.2 Torr delta Pa/delta Ppl) and delta Ppl greater than 15 Torr (0.4 Torr delta Pa/delta Ppl) were significantly different. Under all experimental conditions we found during inspiration a rise in diastolic Patm that is consistent with an increase in left ventricular afterload.(ABSTRACT TRUNCATED AT 250 WORDS)

Electric impedance cuff for the indirect measurement of blood pressure and volume elastic modulus in human limb and finger arteries.

A new plethysmograph, the electric impedance cuff, was designed for the indirect measurement of blood pressure, volume elastic modulus Ev and compliance Ca in human limb arteries. This comprises a compression chamber filled with electrolyte solution and a tetrapolar electric impedance plethysmograph whose electrodes are placed inside the chamber; the former for controlling transmural arterial pressure Pt, and the latter for detecting total limb volume Vo, mean arterial volume Va and its variation delta Va. Systolic and mean arterial pressure in the upper arms, forearms and fingers were measured by detecting pulsatile impedance variation during the gradual (3-5 mm Hg per heart beat) increase (or decrease) in chamber pressure by the volume oscillometric technique. Diastolic and pulse pressure delta P were calculated from these pressure values. Compliance Ca = delta V/delta P and volume elastic modulus Ev = delta P/(delta Va/Va) were recorded at various Pt levels, controlled by the compression pressure. Although this is a kind of impedance plethysmograph, the volume change in a limb segment can be detected by this method without passing electric current through the limb.