Mean arterial pressure (MAP) is estimated at the brachial artery level by adding a fraction of pulse pressure (form factor; = 0.33) to diastolic pressure. We tested the hypothesis that a fixed form factor can also be used at the aortic root level. We recorded systolic aortic pressure (SAP) and diastolic aortic pressure (DAP), and we calculated aortic pulse pressure (PP) and the time-averaged MAP in the aorta of resting adults (n = 73; age 43±14 years). Wave reflection was quantified using the augmentation index. The aortic form factor (range 0.35-0.53) decreased with age, MAP, PP and augmentation index (each P<0.001). The mean form factor value (0.45) gave a reasonable estimation of MAP (MAP = DAP+0.45PP; bias = 0±2mmHg), and the bias increased with MAP (P<0.001). An alternative formula (MAP = DAP+PP/3+5mmHg) gave a more precise estimation (bias = 0±1mmHg), and the bias was not related to MAP. This latter formula was consistent with the previously reported mean pulse wave amplification of 15mmHg, and with unchanged MAP and diastolic pressure from aorta to periphery. Multiple linear regression showed that 99% of the variability of MAP was explained by the combined influence of DAP and SAP, thus confirming major pressure redundancy. Results were obtained irrespective of whether the marked differences in heart period and extent of wave reflection between subjects were taken into account. In conclusion, the aortic form factor was strongly influenced by age, aortic pressure and wave reflection. An empirical formula (MAP = DAP+PP/3+5mmHg) that is consistent with mechanical principles in the arterial system gave a more precise estimate of MAP in the aorta of resting humans. Only two distinct pressure-powered functions were carried out in the (SAP, DAP, MAP, PP) four-pressure set.
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June 24 2002
Empirical estimates of mean aortic pressure: advantages, drawbacks and implications for pressure redundancy
Denis CHEMLA;
*Services de Physiologie Cardio-Respiratoire et d'Anesthésie, CHU de Bicêtre, Université Paris XI, Assistance Publique-Hôpitaux de Paris, UMR 7639 CNRS-Loa-Ensta-Ecole Polytechnique, 94 275 Le Kremlin-Bicêtre, France
Correspondence: Dr Denis Chemla (e-mail denis.chemla@bct.ap-hop-paris.fr).
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Jean-Louis HÉBERT;
Jean-Louis HÉBERT
*Services de Physiologie Cardio-Respiratoire et d'Anesthésie, CHU de Bicêtre, Université Paris XI, Assistance Publique-Hôpitaux de Paris, UMR 7639 CNRS-Loa-Ensta-Ecole Polytechnique, 94 275 Le Kremlin-Bicêtre, France
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Eduardo APTECAR;
Eduardo APTECAR
†Service de Chirurgie Thoracique et Cardiovasculaire, CHU Henri Mondor, 94 010 Créteil, France
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Jean-Xavier MAZOIT;
Jean-Xavier MAZOIT
*Services de Physiologie Cardio-Respiratoire et d'Anesthésie, CHU de Bicêtre, Université Paris XI, Assistance Publique-Hôpitaux de Paris, UMR 7639 CNRS-Loa-Ensta-Ecole Polytechnique, 94 275 Le Kremlin-Bicêtre, France
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Karen ZAMANI;
Karen ZAMANI
*Services de Physiologie Cardio-Respiratoire et d'Anesthésie, CHU de Bicêtre, Université Paris XI, Assistance Publique-Hôpitaux de Paris, UMR 7639 CNRS-Loa-Ensta-Ecole Polytechnique, 94 275 Le Kremlin-Bicêtre, France
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Robert FRANK;
Robert FRANK
‡Service de Cardiologie, Hôpital Jean-Rostand, 94 200 Ivry-sur-Seine, France
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Guy FONTAINE;
Guy FONTAINE
‡Service de Cardiologie, Hôpital Jean-Rostand, 94 200 Ivry-sur-Seine, France
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Alain NITENBERG;
Alain NITENBERG
§Service de Physiologie et d'Explorations Fonctionnelles & INSERM U251, CHU Xavier Bichat, 75018 Paris, France
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Yves LECARPENTIER
Yves LECARPENTIER
*Services de Physiologie Cardio-Respiratoire et d'Anesthésie, CHU de Bicêtre, Université Paris XI, Assistance Publique-Hôpitaux de Paris, UMR 7639 CNRS-Loa-Ensta-Ecole Polytechnique, 94 275 Le Kremlin-Bicêtre, France
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Publisher: Portland Press Ltd
Received:
October 15 2001
Revision Received:
February 13 2002
Accepted:
March 25 2002
Online ISSN: 1470-8736
Print ISSN: 0143-5221
The Biochemical Society and the Medical Research Society © 2002
2002
Clin Sci (Lond) (2002) 103 (1): 7–13.
Article history
Received:
October 15 2001
Revision Received:
February 13 2002
Accepted:
March 25 2002
Citation
Denis CHEMLA, Jean-Louis HÉBERT, Eduardo APTECAR, Jean-Xavier MAZOIT, Karen ZAMANI, Robert FRANK, Guy FONTAINE, Alain NITENBERG, Yves LECARPENTIER; Empirical estimates of mean aortic pressure: advantages, drawbacks and implications for pressure redundancy. Clin Sci (Lond) 1 July 2002; 103 (1): 7–13. doi: https://doi.org/10.1042/cs1030007
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