Pulse wave attenuation measurement by linear and nonlinear methods in nonlinearly elastic tubes

Reasons for the continuing difficulty in making definitive measurements of pulse wave attenuation in elastic tubes and arteries in the presence of reflections are sought. The measurement techniques available were re-examined in elastic tubes mimicking the arterial compliance nonlinearity, under conditions of strong reflection. The pulse was of physiological shape, and two different pulse amplitudes in the physiological range were used. Measurements of pressure, flow-rate and diameter pulsation allowed the deployment of four of the classical linear methods of analysis. In addition, a method of separating the forward- and backward-travelling waves that does not require linearising assumptions was used, and the attenuation in the forward and reverse directions was calculated from the resulting waveforms. Overall, the results obtained here suggest that a fully satisfactory way of measuring arterial attenuation has yet to be devised. The classical linear methods all provided comparable attenuation estimates in terms of average value and degree of scatter across frequency. Increased scatter was generally found at the higher pulse amplitude. When the forward waveforms from the separation were similarly compared in terms of frequency components, the average value at energetic harmonics was similar to both the value indicated by the linear methods and the values predicted from linear theory on the basis of estimated viscous and viscoelastic parameter data. The backward waveforms indicated a physically unreasonable result, attributed as the expression for this technique of the same difficulties that normally manifest in scatter. Data in the literature suggesting that one of the classical methods, the three-point, systematically over-estimates attenuation were not supported, but it was confirmed that this method becomes prone to negative attenuation estimates at low harmonics as pulse amplitude increases. Although the goal of definitive attenuation measurement remains elusive, the task provides a sensitive tool for the examination of the effect of nonlinearities in the arterial system.