Direct measurement of pulse wave propagation in capillaries of the human retina
Phillip Bedggood, Andrew Metha
Abstract
With each contraction of the heart’s left ventricle, a pulse pressure wave surges into the aorta and propagates throughout the vascular tree. The pulse wave drives blood flow forward. Its passage is complex, but it passes more quickly through non-compliant, or stiff, vessels, providing an important signpost of cardiovascular disease. The transparent media of the eye allow direct and non-invasive measurement of this phenomenon within the microvasculature of neural tissue. However, previous estimates differ over three orders of magnitude. Here, we used high spatiotemporal resolution adaptive optics imaging to directly track the pulse wave within individual retinal capillaries in three human subjects. Across 74 unique capillary segments, pulse wave velocity averaged <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" display="inline"> <mml:mrow class="MJX-TeXAtom-ORD"> <mml:mn>6.4</mml:mn> </mml:mrow> <mml:mspace width="thickmathspace"/> <mml:mrow class="MJX-TeXAtom-ORD"> <mml:mo>±</mml:mo> </mml:mrow> <mml:mspace width="thickmathspace"/> <mml:mrow class="MJX-TeXAtom-ORD"> <mml:mn>0.5</mml:mn> </mml:mrow> <mml:mspace width="thickmathspace"/> <mml:mrow class="MJX-TeXAtom-ORD"> <mml:mi mathvariant="normal">m</mml:mi> <mml:mi mathvariant="normal">m</mml:mi> <mml:mrow class="MJX-TeXAtom-ORD"> <mml:mo>/</mml:mo> </mml:mrow> <mml:mi mathvariant="normal">s</mml:mi> <mml:mi mathvariant="normal">e</mml:mi> <mml:mi mathvariant="normal">c</mml:mi> </mml:mrow> </mml:math> ( <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" display="inline"> <mml:mrow class="MJX-TeXAtom-ORD"> <mml:mi mathvariant="normal">m</mml:mi> <mml:mi mathvariant="normal">e</mml:mi> <mml:mi mathvariant="normal">a</mml:mi> <mml:mi mathvariant="normal">n</mml:mi> </mml:mrow> <mml:mspace width="thickmathspace"/> <mml:mrow class="MJX-TeXAtom-ORD"> <mml:mo>±</mml:mo> </mml:mrow> <mml:mspace width="thickmathspace"/> <mml:mrow class="MJX-TeXAtom-ORD"> <mml:mi mathvariant="normal">S</mml:mi> <mml:mi mathvariant="normal">E</mml:mi> <mml:mi mathvariant="normal">M</mml:mi> </mml:mrow> </mml:math> ). There was large variation between vessels; the slowest pulse wave was at most 0.8 mm/sec and the fastest at least 17.6 mm/sec. In 44% of vessels, the pulse wave traveled upstream, in the opposite direction to flow, suggesting wave reflection from downstream collecting junctions.