Contribution of systemic vascular resistance and total arterial compliance to effective arterial elastance in humans

The respective contribution of systemic vascular resistance (R) and total arterial compliance (C) to the arterial load remains to be established in humans. Effective arterial elastance (E-a), i.e., the left ventricular end-systolic pressure (LVESP)-over-stroke volume ratio, is a reliable estimate of arterial load. It is widely accepted that E-a mainly relates to mean aortic pressure (MAP) and thus to the R-to-T ratio (R/T ratio), where T is cycle length. We tested the contribution of R/T and 1/C to E-a in 20 normotensive and 46 hypertensive subjects (MAP range: 84-160 mmHg). The multilinear model applied (E-a = 1.00R/T + 0.42/C - 0.04; r(2) = 0.97). The sensitivity of E-a to a change in R/T was 2.5 times higher than to a similar change in 1/C in both normotensive and hypertensive adults. The LVESP was more strongly related to systolic aortic pressure (SAP; r(2) = 0.94) than to MAP (r(2) = 0.83), and LVESP matched 90% SAP (bias = 0 +/- 5mmHg). An alternative model of E-a is proposed, in which E-a is proportional to the heart rate x SAP product-over-cardiac index ratio whatever the MAP.