Pulse wave type

The pulse wave type may be an indirect indicator of the arterial wall elasticity. There are three types of pulse waves: A, B, and C. And the shape of a pulse wave depends on the time interval between two components of the wave: the direct wave and the reflected wave. A normal shape is when the first component, the direct wave, is formed by a shock volume of blood during systole, and is directed from the center to the periphery. The second component of the pulse wave, the reflected wave, which spreads from the peripheral arteries to the heart, is formed at places where large arteries branch. In young, healthy people without heart disease, the reflected wave reaches the heart at the end of the heart contraction or at the beginning of the relaxation phase. Such timing makes heart work easier and improves blood flow in the heart vessels (coronary vessels), since they are filled with blood mostly during systole. With that, the Type C pulse wave is formed, with two clear peaks: the first standing for the maximum of the first wave, the second—a smaller one—the maximum of the reflected wave. Below is the illustration of the Type C pulse wave:

Type C pulse wave

As the arterial stiffness increases, the pulse wave velocity increases; the reflected waves return to the heart during early systole, significantly increasing the load on the heart, because each previous reflected wave "dampens" the next direct wave. In other words, the heart—already busy pumping blood—has to exert additional effort to resist the untimely pulse wave that overlaps the contraction. A time interval between the maximums of the direct and the reflected waves shortens—which graphically converts into the Type A and B pulse waves. These pulse wave types typical of seniors, as well as patients suffering from cardiovascular diseases. Below are the illustrations of Type A and B pulse waves.

Type B pulse wave Type A pulse wave

It's important to note that not only systemic stiffness of large arteries (a stable value barely falling for any reverse development) but also tone of small arteries (which is very labile and can changed under effect of external factors) can contribute to the shape and type of a pulse wave. This is why, if you receive results not typical for a certain age, make sure the testing rules are observed. You want to align not with the results of single, sporadic measurements but with the over-time measurement results. The most reliable would be a series of results registered over a long period. It's advisable that you carry out the tests at a certain time of the day and on the same hand (preferably your dominant hand). The recommended testing hours are from 9 to 11 AM.

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