Repeated reflection of waves in the systemic arterial system.

Traditional analysis of pulse-wave propagation and reflection in the arterial system treats measured pressure and flow waves as the sum of a single forward wave (traveling away from the heart) and a single backward wave (traveling toward the heart). The purpose of this study was to develop a more general wave reflection theory that allows repeated reflection of these waves. The arterial system was modeled as a uniform viscoelastic tube terminating in a complex load with reflections occurring at the tube load interface and the heart tube interface. The resulting framework considers the forward wave to be the sum of an initial wave plus a series of antegrade waves. Similarly, the backward wave is the sum of a series of retrograde waves. This repeated reflection theory contains within it the traditional forward/backward wave reflection analysis as a special case. In addition, the individual antegrade and retrograde waves, at the tube entrance, are shown to be independent of the tube length. Aortic pressure and flow data, from dog experiments, were used to illustrate the phenomenon of repeated reflections. Alteration of the arterial system loading conditions, brought about through pharmacological intervention, affected the number and morphology of repeated waves. These results are compared with those found in traditional forward/backward reflection analysis.