A unified mechanism for the water hammer pulse and pulsus bisferiens in severe aortic regurgitation: Insights from wave intensity analysis
The carotid bisferiens pulse and the radial water hammer pulse are typical of severe chronic aortic regurgitation. Little is known about the mechanism of these classic cardiovascular signs identified on physical examination. We report the first characterization of these abnormal pulse patterns using...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
BMC
2017-12-01
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| Series: | Artery Research |
| Subjects: | |
| Online Access: | https://www.atlantis-press.com/article/125924952/view |
| _version_ | 1811301389398179840 |
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| author | Julio A. Chirinos Scott R. Akers Jan A. Vierendeels Patrick Segers |
| author_facet | Julio A. Chirinos Scott R. Akers Jan A. Vierendeels Patrick Segers |
| author_sort | Julio A. Chirinos |
| collection | DOAJ |
| description | The carotid bisferiens pulse and the radial water hammer pulse are typical of severe chronic aortic regurgitation. Little is known about the mechanism of these classic cardiovascular signs identified on physical examination. We report the first characterization of these abnormal pulse patterns using wave intensity analysis (WIA) in a patient with severe aortic regurgitation. We demonstrate that an abnormally pronounced forward-traveling mid-systolic suction wave, which immediately followed the initial forward-traveling compression wave from ventricular contraction, explained these pulse patterns. This suction wave likely resulted from blood inertia, arising from a ventricle ejecting a very large stroke volume into a vasodilated arterial tree. Our report demonstrates a novel pulsatile hemodynamic mechanism that unifies the pathogenesis of the bisferiens pulse and the water-hammer pulse in severe aortic regurgitation. |
| first_indexed | 2024-04-13T07:07:59Z |
| format | Article |
| id | doaj.art-b1f767e3734747a0b2ef2c597588d69a |
| institution | Directory Open Access Journal |
| issn | 1876-4401 |
| language | English |
| last_indexed | 2024-04-13T07:07:59Z |
| publishDate | 2017-12-01 |
| publisher | BMC |
| record_format | Article |
| series | Artery Research |
| spelling | doaj.art-b1f767e3734747a0b2ef2c597588d69a2022-12-22T02:56:56ZengBMCArtery Research1876-44012017-12-012110.1016/j.artres.2017.12.002A unified mechanism for the water hammer pulse and pulsus bisferiens in severe aortic regurgitation: Insights from wave intensity analysisJulio A. ChirinosScott R. AkersJan A. VierendeelsPatrick SegersThe carotid bisferiens pulse and the radial water hammer pulse are typical of severe chronic aortic regurgitation. Little is known about the mechanism of these classic cardiovascular signs identified on physical examination. We report the first characterization of these abnormal pulse patterns using wave intensity analysis (WIA) in a patient with severe aortic regurgitation. We demonstrate that an abnormally pronounced forward-traveling mid-systolic suction wave, which immediately followed the initial forward-traveling compression wave from ventricular contraction, explained these pulse patterns. This suction wave likely resulted from blood inertia, arising from a ventricle ejecting a very large stroke volume into a vasodilated arterial tree. Our report demonstrates a novel pulsatile hemodynamic mechanism that unifies the pathogenesis of the bisferiens pulse and the water-hammer pulse in severe aortic regurgitation.https://www.atlantis-press.com/article/125924952/viewPulsatile hemodynamicsArterial tonometryAortic regurgitationWater hammer pulsePulsus bisferiensPhysical exam |
| spellingShingle | Julio A. Chirinos Scott R. Akers Jan A. Vierendeels Patrick Segers A unified mechanism for the water hammer pulse and pulsus bisferiens in severe aortic regurgitation: Insights from wave intensity analysis Artery Research Pulsatile hemodynamics Arterial tonometry Aortic regurgitation Water hammer pulse Pulsus bisferiens Physical exam |
| title | A unified mechanism for the water hammer pulse and pulsus bisferiens in severe aortic regurgitation: Insights from wave intensity analysis |
| title_full | A unified mechanism for the water hammer pulse and pulsus bisferiens in severe aortic regurgitation: Insights from wave intensity analysis |
| title_fullStr | A unified mechanism for the water hammer pulse and pulsus bisferiens in severe aortic regurgitation: Insights from wave intensity analysis |
| title_full_unstemmed | A unified mechanism for the water hammer pulse and pulsus bisferiens in severe aortic regurgitation: Insights from wave intensity analysis |
| title_short | A unified mechanism for the water hammer pulse and pulsus bisferiens in severe aortic regurgitation: Insights from wave intensity analysis |
| title_sort | unified mechanism for the water hammer pulse and pulsus bisferiens in severe aortic regurgitation insights from wave intensity analysis |
| topic | Pulsatile hemodynamics Arterial tonometry Aortic regurgitation Water hammer pulse Pulsus bisferiens Physical exam |
| url | https://www.atlantis-press.com/article/125924952/view |
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