Effects of cardiac timing and peripheral resistance on measurement of pulse wave velocity for assessment of arterial stiffness

investigate the effects of heart rate (HR), left ventricular ejection time (LVET) and wave reflection on arterial stiffness as assessed by pulse wave velocity (PWV), a pulse wave propagation simulation system (PWPSim) based on the transmission line model of the arterial tree was developed and was applied to investigate pulse wave propagation. HR, LVET, arterial elastic modulus and peripheral resistance were increased from 60 to 100 beats per minute (bpm), 0.1 to 0.45 seconds, 0.5 to 1.5 times and 0.5 to 1.5 times of the normal value, respectively. Carotid-femoral PWV (cfPWV) and brachial-ankle PWV (baPWV) were calculated by intersecting tangent method (cfPWV(tan) and baPWV(tan)), maximum slope (cfPWV(max) and baPWV(max)), and using the Moens-Korteweg equation (cfPWV(co) and baPWV(co)). Results showed cfPWV and baPWV increased significantly with arterial elastic modulus but did not increase with HR when using a constant elastic modulus. However there were significant LVET dependencies of cfPWV(tan) and baPWV(tan) (0.17 +/- 0.13 and 0.17 +/- 0.08 m/s per 50 ms), and low peripheral resistance dependencies of cfPWV(tan), cfPWV(max), baPWV(tan) and baPWV(max) (0.04 +/- 0.01, 0.06 +/- 0.04, 0.06 +/- 0.03 and 0.09 +/- 0.07 m/s per 10% peripheral resistance), respectively. This study demonstrated that LVET dominates the effect on calculated PWV compared to HR and peripheral resistance when arterial elastic modulus is constant.