Pulse waves. Role in the implementation and regulation of hemodynamics Part 2. The role of pulse waves in the transmission of information signals, in the implementation and regulation of hemodynamics

Based on the analysis and discussion of the results of this study pulse pressure waves and pulse flow waves, the reaction of arterial vessels to changes in hemodynamics when pulse waves pass through them, as well as literature data, the following assumptions can be made:

– pulse pressure waves store the energy of the contracting myocardium in the form of a pressure gradient. Part of the energy of the pulse pressure wave front is spent on its propagation along the artery wall. Another portion of the pulse pressure wave energy is probably converted into a pulse flow wave, promoting the movement of a certain volume of blood into the artery;

– the duration of the delay time of pulse waves relative to the phases of myocardial excitation and the cardiac cycle reflects the direction of the arterial vessels reaction to a rapid change in arterial blood pressure and blood flow to them. Under these conditions an increase in the delay time and a decrease in the velocity of pulse waves propagation indicate on relaxation the smooth myocytes of the arterial wall and vessel expansions. The delay time shortening and increase in the velocity propagation indicate on the reaction of narrowing arterial vessels.

– pulse wave parameters encode a variety of information about the work of the heart (heart rate, rhythm, and stroke volume), the state of hemodynamics (blood pressure level and the dynamics of its changes, blood volume, blood flow velocity, and blood properties), and vessels reaction to their changes (constriction or dilation);

 – pulse waves propagating through arteries and blood at high velocity initiate the basic response of arterial vessels to changes in the pulse wave’s parameters. With a rapid increase in pressure at the front of pulse pressure wave, and with a rapid increase in velocity and blood volume during the passage of pulse pressure and pulse flow waves, arterial vessels may initially respond with rapid myogenic constriction followed by their dilation. The vascular response occurs during each cardiac cycle, and it is an integral part of the systemic mechanisms of hemodynamic correspondence of blood volumes flowing from the proximal arteries and flowing further into distal vessels, and prevention of macro- and microcirculation correspondence disorders;

 – there are grounds for assumption that pulse waves are involved in the implementation of the mechanism of maintaining the correspondence of macro- and microcirculation, by their influence on the balance of factors and substances with vasoconstrictor (myogenic constriction, endothelin, norepinephrine (NE), peptide Y) and vasodilator effects (CGRP peptide, nitric oxide (NO). Changing this balance is necessary for the transition from myogenic vasoconstriction to dilation, for reducing peripheral resistance, the possibility of the pronounced reflected waves formation, and return of vessels to the intermediate lumen to restore their readiness to respond to new changes in hemodynamics;

 – dysfunction of the basic central reflex mechanisms and/or peripheral mechanisms of dynamic assessment of pulse wave parameters, as well as the reaction of the heart, large and small arteries initiated by the pulse wave, may be the cause of pathological changes in hemodynamics. Thus, a disturbance of the central reflex mechanisms of dynamic assessment of pulse wave’s parameters by the aortic arch and carotid artery receptors under changes of the arterial blood pressure can result in the development of orthostatic hypotension up to temporary loss of consciousness. It can be assumed that such dysfunction of the peripheral mechanisms of dynamic assessment of pulse wave’s parameters, and initiated by pulse waves small arteries and arterioles response to changes of hemodynamics, may be a component of arterial hypertension pathogenesis, as well as disturbances of hemodynamic correspondence of macro- and microcirculation in heart failure, intravenous fluid infusion for blood loss, sepsis and other conditions in intensive care units.

Additional research is required to verify the assumptions made about the role of pulse waves in implementation and regulation of hemodynamics in a healthy body, and the possible significance of its disturbance in the mechanisms of development of cardio vascular and other diseases.

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