What happens to peripheral amplification in aortic stenosis ?

Pressure wave A pressure wave, consists of many sinusoidal harmonics . Role of Pulse Pressure Amplification in Arterial Hypertension : Experts' Opinion and Review of the Data: Alberto P. Avolio, Luc M. Van Bortel, Pierre Boutouyrie, John R. Cockcroft, Carmel M McEniery, Athanase D. Protogerou, Mary J. Roman, Michel E. Safar, Patrick Segers and Harold Smulyan; Hypertension. 2009;54:375-383 .

Harmonic a sinusoidal component of a periodic wave or quantity having a frequency that is an integral multiple of the fundamental frequency

Role of Pulse Pressure Amplification in Arterial Hypertension : Experts' Opinion and Review of the Data: Alberto P. Avolio, Luc M. Van Bortel, Pierre Boutouyrie, John R. Cockcroft, Carmel M McEniery, Athanase D. Protogerou, Mary J. Roman, Michel E. Safar, Patrick Segers and Harold Smulyan; Hypertension. 2009;54:375-383 .

PATHOPHYSIOLOGICAL BASIS OF CENTRAL BP Figure 2 Propagation of the BP curve from the thoracic to the aortic bifurcation Note the change in the shape of the BP curve with the amplification of SBP and PP and minor modifications of DBP and MBP. Major branches of the aorta are indicated. SAFAR ME et al. Central blood pressure and hypertension: role in cardiovascular risk assessment. Clinical Science (2009) 116, 273–282 Williams B, Lacy PS. Central aortic pressure and clinical outcomes. Journal of Hypertension 2009, Vol 27 No 6

Review of literature The effect of aortic stenosis on peripheral amplification is a matter of controversy

Farrar and Gray described increased amplification of the first and second harmonics in the descending aorta in children with aortic stenosis. FARRAR JF, GRAY RE: The pulse of aortic stenosis during childhood. Br Heart J 27: 199, 1965

Wright and Wood found lower than normal amplification ratios in aortic stenosis. Am Heart J.1958 Jul;56(1):64;The value of aortic and radial pressure pulses in the diagnosis of cardiovascular disorders.WRIGHT JL, WOOD EH

the preoperative group showed no such relationship. positive correlation between aortic valve area and amplification aortic valve stenosis group after surgery the preoperative group showed no such relationship. RICHARD E. HAWKER, CARLOS A. SEARA and L. JEROME KROVETZ Circulation. 1974;50:181-187

O'Rourke found that in adults, amplification between root of aorta and brachial artery was less in patients with all types of aortic valve disease than in controls OROURKE MF; Influence of ventricular ejection on the relationship between central aortic and brachial pressure pulse in man. Cardiovasc Res 4: 291, 1970

amplification in the descending aorta was not related to aortic valve disease O ROURKE MF, BL.AZEK JV, MORREELS CL JR, KROVETZ LJ: Pressure wave transmission along the human aorta: Changes with age and in arterial degenerative disease. Cire Res 23: 567, 1968

lower harmonics are most amplified in the upper limbs the higher harmonics are relatively more amplified in the lower limbs. in aortic stenosis most of the energy of the wave is in the lower harmonics amplification in upper limb arteries are seen. RICHARD E. HAWKER, CARLOS A. SEARA and L. JEROME KROVETZ Circulation. 1974;50:181-187 ,