Measurement of pulse wave velocity (XII.)
DEP. OF PHYSIOLOGY, FAC. OF MEDICINE, MU, 2015 © JANA HRUŠKOVÁ


Definition of pulse wave
• Pulse wave arises during heart revolution, when blood is ejected.
• Single pulse is propagated in arterial wall through whole arterial system

Pulse wave curve
Pulse wave is composed of two waves: forward traveling wave and backward traveling wave. Forward
wave travels from the heart to periphery. Backward wave is rebounded from bifurcations of arteries
in periphery. It travels to the heart, interferes with forward wave and both together form shape of
the pulse wave curve.
Amplitude of pulse wave increases in periphery due to increased pulse wave velocity.
The shape of the curve is depend on the place where it is measured. The smallest amplitude is
common in radial artery, greatest one in dorsal pedis artery.
Backward traveling wave
Forward traveling wave
Pulse wave in aorta
Pulse wave in periphery

Pulse wave velocity (PWV)
• Velocity of pulse wave propagation varies from 6 m/s (in aorta) to 20 m/s (in periphery)
• It is much greater than velocity of blood flow (0.8 – 1.0 m/s)

Factors affected the pulse wave velocity
◦
◦Age
◦Sex
◦Genetic load
◦
◦Smoking
◦Obesity
◦Diabetes
◦Dyslipidaemia

Changes of pulse wave in elderly people
Increased PWV and vanishing of typical characteristics of shape of the pulse wave due to:
1.Increased arterial stiffness
2.Increased blood pressure
•
•

•
•
Forward wave
Backward wave
Total wave
Young man:
High arterial compliance → lower pulse wave velocity  →  backward wave meets forward wave during
the beginning of diastole → lower pulse amplitude
ŠPÁC, Jiří. Hypertenze a vlastnosti arteriální stěny. Kardiofórum, 2006, roč. 4, č. 4, s. 9-13.
ISSN 1214-2255.
Elder man:
decreased arterial compliance → increased pulse wave velocity  →  backward wave meets forward wave
during the end of systole → increased pulse amplitude

Changes of pulse wave in children
Increased PVW and vanishing of typical characteristics of shape of the pulse wave due to:
1.Smaller length of arterial system
2.Longer ejection time
•Relatively long ejection time to small body and higher heart rate leads to changes of summation of
consecutive pulse waves

Normal values of PWV
 Reference intervals for carotid-femoral index (PWV)
 If the measured value is higher than 90. percentile for the age, it is the sign of cardiovascular
pathology (such as atherosclerosis) and such person has significant higher risk for cardiovascular
diseases.

Measurement of PWV

1.Direct method
◦Catheterisation
2.Indirect methods
◦Ultrasonography
◦Sphygmography
◦Bioimpedance analysis

Sphygmography
•Carotid-femoral PWV („gold standard“) measured from pulse on a. carotis, a. femoralis and ECG.
•Well reproducible method (differences between two measurement are < 5 %),
• Arterial segment is analysed as complexly
• In clinical practise, it is important to take in consideration the actual blood pressure.
Arterial compliance is a function of blood pressure and arterial hypertension increases rigidity of
the arterial wall.
•Aortal PWV is the most important parameter, because it reflects  dampening function  of the
central arterial system.
A
B
T1
T2
d
PWV= d/ (T2-T1)
A
B