Arterial reservoir characteristics and central-to-peripheral blood pressure amplification in the human upper limb

Background: Arterial reservoir characteristics are related to blood pressure (BP) and independently predict cardiovascular events. It is unknown if arterial reservoir characteristics are modified from the central-to-peripheral large arteries and whether there is a contributory role to BP amplification. The aim of this study was to assess central-to-peripheral changes in arterial reservoir characteristics and determine associations with BP.

Methods: Reservoir pressure (RP) and excess pressure (XSP) were derived from intra-arterial BP waveforms among 51 participants (aged 63 ± 13 years, 63% men) undergoing clinically indicated cardiac angiography. BP waveforms were recorded in the ascending aorta, brachial (mid-humerus) and radial (wrist) arteries via catheter pull-back.

Results: There was no significant difference in RP between arterial sites (54  ±  15, 53  ±  15 and 52  ±  17  mm Hg for the aorta, brachial and radial artery, respectively; P =  0.68). Conversely, XSP increased stepwise from the aorta to the brachial and radial arteries (24  ±  11, 42  ±  14 and 53  ±  16  mm Hg; P  <  0.001), as did SBP (134  ±  18, 141  ±  16 and 146  ±  19  mm Hg; P  =  0.004). There were highly significant associations between RP and SBP at all arterial sites (r  =  0.821, 0.649 and 0.708; P  <  0.001 for all), but the strength of associations between peak XSP and SBP increased significantly from the aorta to the radial artery (r  =  0.121 and 0.508; z  =  3.04; P =  0.004).

Conclusion: Arterial reservoir characteristics are modified through the large arteries of the upper limb. Although RP remains relatively constant, XSP increases significantly and is highly related to BP (SBP and pulse pressure) amplification. These data provide a new understanding on arterial reservoir characteristics and large-artery BP physiology.