Arterial Hemodynamics and Wave Reflections

Abstract

Despite years of research, there are still some contentious aspects of arterial hemodynamics that have remained unresolved. These were discussed during a workshop entitled Arterial hemodynamics: past, present and future held in London on June 14 and 15, 2016, with keynote contributions by Nico Westerhof, Kim Parker and Michael O’Rourke. In follow-up of that meeting, we formulated a list of potential consensus statements informed by discussion at the meeting in London and quantified the degree of agreement and invited comments from the participants of the workshop. The survey was set up making use of Google forms.

Overall the responses and comments show a high measure of quantitative agreement with the various proposed ‘consensus’ statements. There is a large consensus on the nature and role of wave reflections in arterial hemodynamics, while consensus gets more blunted when it comes to methods and paradigms for the analysis of hemodynamics.

The followed methodology provided an elegant way to collect input from a broad scientific community, but we also learned that statements were too broadly formulated, making it harder to obtain clear-cut positions on specific topics. Also, it is highly unlikely that all participants to the poll had the same degree of expertise on all of the topics. As we did not want to weigh answers according to a presumed level of competence (what may also be another source of bias), all answers were equally valued.

Taken together, these statements seem a useful basis for proceeding with a more detailed and comprehensive consensus document on the current understanding and approaches to analysis of the pulse waveform. Future efforts should be directed at identifying remaining areas of dispute and future topics for research.