Measurement arterial compliance, clinical significance, factors

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Charles McCarthy
Measurement arterial compliance, clinical significance, factors

The arterial compliance is one of the physical properties of the arteries and expresses their ability to expand and contract in the face of volume changes that occur due to variations in blood pressure.

All blood vessels, veins and arteries are compliant, however, this characteristic is not the same in all vessels, since it is affected according to the volume handled by each one. Thus, the values ​​of this parameter are different in small-caliber glasses or larger ones..

Arteries, arterioles and capillaries. From Community Emergency Response Team - WIKIMEDIA COMMONSFile: Capillary system CERT.jpg, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=66830274

Cardiovascular problems affect the compliance of the blood vessels, making them more rigid at times, therefore it is considered a risk marker in patients with this type of disease..

The measurement of arterial compliance is a widely used method to determine the degree of cardiovascular disease and the response to treatment. In addition, it can aid in the early diagnosis of conditions such as high blood pressure..

One of the most used ways to measure arterial compliance is through the calculation of the speed of traffic wave, which determines the time it takes for the pulse wave to travel from one artery to another.

Its value lies in the fact that it is a non-invasive method and has great predictive value for cardiovascular disease.

Article index

  • 1 Compliance and blood pressure
  • 2 Measurement of arterial compliance
    • 2.1 Ultrasound
    • 2.2 Nuclear magnetic resonance (NMR)
    • 2.3 Speed ​​of the traffic wave
  • 3 Factors that alter arterial compliance
  • 4 Clinical significance
  • 5 References

Compliance and blood pressure

Compliance is a property of blood vessels that allows them to expand according to the amount of blood that passes through them. This process is mediated by blood pressure.

In arteries, compliance is less than in veins, since the elasticity of the veins is 8 times greater, so they can increase their diameter to a greater degree.

The mathematical formula for calculating arterial compliance expresses the fraction of blood volume per millimeter of mercury (mmHg) of blood pressure, as follows:

DA = volume / BP mmHg

Clarify that in the equation DA = arterial compliance and BP = arterial pressure.

Compliance will be altered by varying any of the parameters used for its measurement. Higher blood pressure, for example, lower compliance.

Measurement of arterial compliance

An advantage of measuring this value over other methods is that it can be done in a non-invasive way. It can be done directly, through ultrasound, or indirectly with nuclear magnetic resonance or by measuring the speed of the transit wave.

Ultrasound

Ultrasound evaluation can be used to assess arterial compliance. Measurement in large arteries such as the abdominal or femoral aorta is preferred.

To perform the measurement, the doctor must look for the image where the arterial wall is best observed and start recording for a few minutes.

Ultrasound of the common carotid artery. By The original uploader was Drickey at English Wikipedia. - Transferred from en.wikipedia to Commons by Shizhao using CommonsHelper., CC BY-SA 2.5, https://commons.wikimedia.org/w/index.php?curid=11037872

The video is analyzed to find the moment of greatest and least expansion of the studied vessel and with these values ​​the compliance is calculated from a mathematical formula that includes the blood pressure value..

Although ultrasound has the advantage of being a non-invasive method, the result depends on the doctor who is conducting the study. That is, the reliability of the final value is conditional on the experience of the doctor who performed it..

Nuclear Magnetic Resonance (NMR)

MRI calculates the degree of arterial stiffness quite accurately by measuring the vascular diameter. The most frequently studied artery is the abdominal aorta.

Its main disadvantage is that it is an expensive study and requires qualified personnel to handle the equipment and interpret the results..

Traffic wave speed

The easiest and most widely used way to measure arterial compliance is done by calculating a parameter called traffic wave speed. This is a vibration wave caused by the contraction of the heart or systole, when pumping blood.

The time it takes for this wave to travel through the arterial system is known as the speed of the transit wave. What is done is to measure the transit time of the pulse between two points of the arterial vascular tree. This time is inversely proportional to the compliance of the artery, that is, the calculation is done indirectly..

The speed of the transit wave is directly related to arterial stiffness, which is the absence of changes in expansion of an artery in front of blood flow due to multiple reasons, including atherosclerosis and arterial hypertension.

The most widely used method is tonometry, which is performed with a device called tonometer. The arteries to be studied are chosen, the ones most frequently used are the carotid and the femoral, with the patient lying on his back. Two tonometers are positioned, one in each artery and these automatically record the speed of passage and express it in milliseconds.

Factors that alter arterial compliance

The expansion of the arteries before the blood volume is a phenomenon that occurs due to the content of elastin in the structure of its wall.

When elastin decreases and the amount of collagen in the vascular wall increases, compliance is decreased.

Compliance is one of the first parameters to be altered in patients with hypertension and other diseases with cardiovascular repercussions, such as diabetes..

Changes of the arterial wall in arterial hypertension. Normal der; HT left From hugovillarroelabrego, Public Domain, https://commons.wikimedia.org/w/index.php?curid=2608771

Physiologically, age is one of the main causes of elastin loss and decreased distension capacity..

Conversely, aerobic exercise improves elasticity and, as a consequence, the compliance of blood vessels.

Clinical significance

In hypertensive patients, the compliance of the arteries is increased. This is due to increased arterial stiffness and arteriosclerotic changes that promote the loss of elasticity of the blood vessel..

Arterial compliance is a parameter that can help diagnose hypertension in its early stages..

In addition, it is a predictive factor of cardiovascular disease since its decrease is associated with other diseases, such as obesity and hypertriglyceridemia, which alter the normal functioning of the circulatory system.

Proper treatment of high blood pressure and other cardiovascular diseases improves arterial compliance. Therefore, knowing this value, the patient's response to the administered treatment can be evidenced..

References

  1. Godia, E. C; Madhok, R; Pittman, J; Trocio, S; Branches, R; Cabral, D; Rundek, T. (2007). Carotid artery distensibility: a reliability study. Journal of ultrasound in medicine: official journal of the American Institute of Ultrasound in Medicine. Taken from: ncbi.nlm.nih.gov
  2. Nichols, W. (2005). Clinical measurement of arterial stiffness obtained from noninvasive pressure waveforms. American Journal of Hypertension. Taken from: ncbi.nlm.nih.gov
  3. Pieper, T; Latus, H; Schranz, D; Kreuder, J; Reich, B; Gummel, K; Voges, I. (2019). Aortic elasticity after aortic coarctation relief: comparison of surgical and interventional therapy by cardiovascular magnetic resonance imaging. BMC cardiovascular disorders. Taken from: ncbi.nlm.nih.gov
  4. Cavalcante, J; Lima, J; Redheuil, A; Mouaz, H. (2011). Aortic Stiffness: Current understanding and future directions. JACC. Taken from: sciencedirect.com
  5. Cohn, J; Duprez, D; Grandits, G. (2005). Arterial elasticity as part of a comprehensive assessment of cardiovascular risk and drug treatment. Taken from: ahajournals.org
  6. Haluska, B; Jeffries, L; Carlier, S; Marwick, T. (2010). Measurement of arterial distensibility and compliance to assess prognosis, atherosclerosis. Taken from: sciencedirect.com
  7. Reneman, R. S; Hoeks A. P. (1995). Arterial distensibility and compliance in hypertension. Neth J Med. Taken from: ncbi.nlm.nih.gov
  8. Sáez-Pérez, J. M. (2008). Arterial compliance: one more parameter to assess cardiovascular risk. Family Medicine - SEMERGEN. Taken from: elsevier.es
  9. Nannini, D. (2016). Pulse wave velocity. Taken from: saha.org.ar
  10. Schmitz, K. H; Arnett, D. K; Bank, A; Liao, D; Evans, G. W; Evenson, K. R; Stevens, J; Sorlie, P; Folsom, A. R. (2001). Arterial distensibility and physical activity in the ARIC study. Med Sci Sports Exerc. Taken from: ncbi.nlm.nih.gov
  11. Palma, J. L. (2002). Non-invasive methods for the evaluation of the physical properties of the great arteries in arterial hypertension. Taken from: revistanefrologia.com

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