Depending on the subject, the component pulse structure is more or less obvious in the pulse spectrum. Generally, athletic subjects, due to their softer arteries, have lower arterial pulse propagation velocities. Consequently their renal and iliac reflection component pulses arrive later. Also, because their thoracic aortas are very pliable, the renal reflection coefficient tends to be significant. Graph A shows data from, arterially speaking, the slowest subject. Females statistically have lower pulse velocities than males. The subject is also tall and young, all of which contributes to very well resolved component pulses.
Notice the distension of her renal reflection with increasing blood pressure. See explanation for Graph C below.
Notice the distension of her renal reflection with increasing blood pressure. See explanation for Graph C below.
The subject whose data is shown in graph B has a very diminished renal component pulse amplitude, although the deflection in the side of the #1 pulse is clearly visible. Vascular health-wise this individual is in a more challenged state. Other factors, such as diminished vagal tone as demonstrated by a very low heart rate variability, support this conclusion.
Graphs C show the change of the same patient’s radial pulse signature due to significantly different blood pressures. Notice the significantly distended renal reflection component pulse at the higher blood pressure. With increasing blood pressure the thoracic aorta, being the softest artery in the body, dilates the most. As a result the renal reflection grows relative to the primary pulse as well as the iliac reflection and the harmonic reflections (the last of which is swallowed by the next pulse).
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21 y. f. runner
27 y. m. hypertensive
47 y. f. hypertensive
90 y. f. hypertensive
A
B
C
D
Graph D presents the radial pulsation of a 90 y old female. Her renal reflection is noticeable because A. It arrives earlier due to increased arterial pulse propagation velocities and B. presumably the reflection is larger due to thoracic arterial hardening.
Attempts have been made to quantify the amplitude ratio of the renal reflection and the primary component pulse through the “augmentation index”. Studies have yielded conflicting results as to its usefulness. This is not surprising in light of the radial pulse lineshapes shown in graphs A & D. Both subjects would be quantified as having large augmentation indices, but for very different underlying physiological reasons.
Attempts have been made to quantify the amplitude ratio of the renal reflection and the primary component pulse through the “augmentation index”. Studies have yielded conflicting results as to its usefulness. This is not surprising in light of the radial pulse lineshapes shown in graphs A & D. Both subjects would be quantified as having large augmentation indices, but for very different underlying physiological reasons.
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