What happens to peripheral amplification in aortic stenosis ?

Pressure waveA pressure wave, consists of many sinusoidal

harmonics

Role of Pulse Pressure Amplification in Arterial Hypertension : Experts' Opinion and Review of the Data: Alberto P. Avolio, Luc M. Van Bortel, Pierre Boutouyrie, John R. Cockcroft, Carmel M McEniery, Athanase D. Protogerou, Mary J. Roman, Michel E. Safar, Patrick Segers and Harold Smulyan; Hypertension. 2009;54:375-383

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Harmonic a sinusoidal component of a periodic wave or

quantity having a frequency that is an integral multiple of the fundamental frequency

Role of Pulse Pressure Amplification in Arterial Hypertension : Experts' Opinion and Review of the Data: Alberto P. Avolio, Luc M. Van Bortel, Pierre Boutouyrie, John R. Cockcroft, Carmel M McEniery, Athanase D. Protogerou, Mary J. Roman, Michel E. Safar, Patrick Segers and Harold Smulyan; Hypertension. 2009;54:375-383

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PATHOPHYSIOLOGICAL BASIS OFCENTRAL BP

• SAFAR ME et al. Central blood pressure and hypertension: role in cardiovascular risk assessment. Clinical Science (2009) 116, 273–282• Williams B, Lacy PS. Central aortic pressure and clinical outcomes. Journal of Hypertension 2009, Vol 27 No 6

Review of literatureThe effect of aortic stenosis on peripheral

amplification is a matter of controversy

Farrar and Gray described increased amplification of the first and second harmonics in the descending aorta in children with aortic stenosis.

FARRAR JF, GRAY RE: The pulse of aortic stenosis duringchildhood. Br Heart J 27: 199, 1965

Wright and Wood found lower than normal amplification ratios in aortic stenosis.

Am Heart J.1958 Jul;56(1):64;The value of aortic and radial pressure pulses in the diagnosis of cardiovascular disorders.WRIGHT JL, WOOD EH

positive correlation between aortic valve area and amplification aortic valve stenosis group after surgery

the preoperative group showed no such relationship.

RICHARD E. HAWKER, CARLOS A. SEARA and L. JEROME KROVETZCirculation. 1974;50:181-187

O'Rourke found that in adults, amplification between root of aorta and brachial artery was less in patients with all types of aortic valve disease than in controls

OROURKE MF; Influence of ventricular ejection on the relationship between central aortic and brachial pressure pulse in man. Cardiovasc Res 4: 291, 1970

amplification in the descending aorta was not related to aortic valve disease

O ROURKE MF, BL.AZEK JV, MORREELS CL JR, KROVETZ LJ:Pressure wave transmission along the human aorta: Changeswith age and in arterial degenerative disease. Cire Res 23:567, 1968

lower harmonics are most amplified in the upper limbs

the higher harmonics are relatively more amplified in the lower limbs.

in aortic stenosis most of the energy of the wave is in the lower harmonics

amplification in upper limb arteries are seen.

RICHARD E. HAWKER, CARLOS A. SEARA and L. JEROME KROVETZCirculation. 1974;50:181-187,