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Cardiovasc Res. 1990 Jun;24(6):478-84.

The areas ratio of normal arterial junctions and its implications in pulse wave reflections.

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Department of Engineering, University of Leicester, United Kingdom.



The aim of the study was to establish measurements for the area ratios of normal arterial junctions at various anatomical sites in order to estimate the significance of pulse wave reflections in the healthy arterial system.


Coronary cineangiograms were used for the coronary junctions measurements and routine arteriograms for the rest of the junctions studied. A pair of digital calipers served to take measurements at a distance of one vessel diameter from the junction centre.


A bell shaped distribution of arterial area ratios was found with mean value for coronary bifurcations of 1.179 (95% confidence limits, 1.138-1.220). Slightly higher values were found for the higher order coronary junctions. Other junctions had similar area ratio values with the exception of the aortoiliac junctions where the area ratio was found 0.848 (0.775-0.920). Overall area ratio was 1.14 (1.113-1.167). Asymmetrical coronary bifurcations had higher area ratio than symmetrical ones (p less than 0.05).


In the majority of cases the area ratios are in close agreement with the theoretically predicted values for forward matched junctions. Minimal pulse wave reflections are therefore expected to arise from the junctions of a healthy arterial system. We therefore consider that, contrary to the established view, the presence of reflected waves in the central arterial system is a potential pathological phenomenon and not a characteristic of the healthy system. This may have important theoretical implications for the way hemodynamic findings are interpreted. Finally we suggest that arterial area ratio can be considered as another criterion of normality of arterial junctions in the interpretation of angiograms.

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