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Computer Model Analysis of the Radial Artery Pressure Waveform

Journal of Clinical Monitoring volume 3, pages 220–228 (1987)Cite this article

Abstract

Simultaneous measurements of aortic and radial artery pressures are reviewed, and a model of the cardiovascular system is presented. The model is based on resonant networks for the aorta and axillo-brachial-radial arterial system. The model chosen is a simple one, in order to make interpretation of the observed relationships clear. Despite its simplicity, the model produces realistic aortic and radial artery pressure waveforms. It demonstrates that the resonant properties of the arterial wall significantly alter the pressure waveform as it is propagated from the aorta to the radial artery. Although the mean and end-diastolic radial pressures are usually accurate estimates of the corresponding aortic pressures, the systolic pressure at the radial artery is often much higher than that of the aorta due to overshoot caused by the resonant behavior of the radial artery. The radial artery dicrotic notch is predominantly dependent on the axillo-brachial-radial arterial wall properties, rather than on the aortic valve or peripheral resistance. Hence the use of the radial artery dicrotic notch as an estimate of end systole is unreliable. The rate of systolic upstroke, dP/dt, of the radial artery waveform is a function of many factors, making it difficult to interpret. The radial artery waveform usually provides accurate estimates for mean and diastolic aortic pressures; for all other measurements it is an inadequate substitute for the aortic pressure waveform. In the presence of low forearm peripheral resistance the mean radial artery pressure may significantly underestimate the mean aortic pressure, as explained by a voltage divider model.

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Authors and Affiliations

  1. Department of Anesthesiology, University of Washington School of Medicine, Seattle, WA, 98195

    Howard A. Schwid MD

  2. Anesthesiology Service, Good Samaritan Hospital, Portland, OR, 97210

    Lee A. Taylor MS Eng, MD

  3. Department of Anesthesiology, University of California at San Diego, San Diego, CA, 92102

    N. Ty Smith MD

Authors
  1. Howard A. Schwid MD
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  2. Lee A. Taylor MS Eng, MD
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  3. N. Ty Smith MD
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The authors thank Patricia Dorsa for her secretarial assistance in the preparation of this manuscript.

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Schwid, H.A., Taylor, L.A. & Smith, N.T. Computer Model Analysis of the Radial Artery Pressure Waveform. J Clin Monitor Comput 3, 220–228 (1987). https://doi.org/10.1007/BF03337375

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  • DOI: https://doi.org/10.1007/BF03337375

Key Words

  • Blood pressure: monitoring, arterial
  • Heart: cardiovascular model