P127 Spatial Variation of Reservoir Pressure in Children Assessed with High Fidelity Pressure Measurement in Five Aortic Locations
Artery Research(2018)
摘要
Objective To assess whether reservoir pressure (Pres) in young individuals with a compliant aorta is uniform throughout the aorta, as has recently been reported in older adults with cardiovascular disease (1). Methods High fidelity pressure was measured with a Verrata wire (Philips Volcano) in 5 aortic locations (ascending-to-abdominal) via pull-back in 11 children with a normal aorta (age 10.4 ± 4.9 years, mean ± SD). Pres was calculated using the ‘pressure-only’ approach (2), with exponential fitting over the whole of diastole (1) (WholeDia) or the period when pressure declined in an approximately exponential fashion (ExpDia). Results ExpDia produced a better fit than WholeDia (R2 = 0.99 ± 0.01 vs 0.91 ± 0.11, P < 0.001). P res amplitude (ΔP res ) in the ascending aorta from WholeDia fitting (12.0 ± 4.1 mmHg) was less than with ExpDia fitting (19.0 ± 5.2, P = 0.001). The zero-flow asymptotic pressure (P inf ) obtained from the fitting procedure was negative (non-physiological) in 76% (WholeDia) and 44% (ExpDia) of recordings, but fixing P inf to 37 mmHg (average of physiological values) had little effect on the resulting ΔP res . ΔP res varied by 5.7 ± 3.0 mmHg (WholeDia) and 7.3 ± 3.7 mmHg (ExpDia) between aortic locations (both P<0.001 compared with zero), corresponding to 44% ± 30% and 38% ± 17% of average ΔP res respectively. Maximum instantaneous spatial differences in P res amounted to a substantial percentage of ΔP res (45% ± 37% WholeDia; 24% ± 26% ExpDia) and were not reduced by time and/or pressure offsets to align P res foot. Conclusion In young individuals, P res was sensitive to the fitting period and often resulted in non-physiological P inf values. Regardless of calculation method or alignment, P res was not uniform along the aorta.
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