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Revisiting the Windkessel Function: Toward Accessible Assessment of Central Arterial Health
Jun Sugawara1,2
1Integrated Research Center for Self-Care Technology, National Institute of Advanced Industrial Science and Technology (AIST), Tsukuba 305-8566, Japan.
Insights
Cardiovascular disease (CVD) risk increases with arterial stiffening, impairing heart function. Simplified screening methods like brachial-ankle pulse wave velocity (baPWV) offer accessible early detection for preventing CVD.
Area of Science:
- Cardiovascular medicine
- Biomedical engineering
- Public health
Background:
- Cardiovascular disease (CVD) is a leading global cause of mortality.
- Arterial stiffening, especially in elastic arteries, compromises the Windkessel function, increasing cardiovascular risk.
- The gold standard for assessing aortic stiffness, carotid-femoral pulse wave velocity (cfPWV), is complex for routine use.
Purpose of the Study:
- To highlight the pathophysiological importance of arterial Windkessel function.
- To emphasize the need for practical methods to assess arterial stiffness.
- To discuss innovations in CVD screening tools.
Main Methods:
- Review of existing literature on arterial stiffness and CVD.
- Discussion of simplified pulse wave velocity (PWV) techniques, including brachial-ankle PWV (baPWV).
- Exploration of single-cuff oscillometric devices for home-based assessment.
Main Results:
- Simplified PWV methods like baPWV are emerging as practical alternatives to cfPWV for population screening.
- Single-cuff oscillometric devices offer enhanced accessibility for home healthcare.
- Accuracy of simplified methods relies on model assumptions and calibration.
Conclusions:
- Innovations are shifting CVD screening from complex lab measurements to simplified, data-driven tools.
- Practical assessment of Windkessel function is crucial for early CVD detection and prevention.
- Accessible screening tools are vital for public health initiatives targeting CVD.
Abstract:
Cardiovascular disease (CVD) remains the leading cause of death worldwide, accounting for nearly one-third of global mortality. Arterial stiffening, particularly in the central elastic arteries, impairs the Windkessel (cushioning and pumping) function and contributes to cardiovascular risk beyond traditional factors. Carotid-femoral pulse wave velocity (cfPWV) is established as the gold standard for assessing aortic stiffness and predicting cardiovascular and all-cause mortality; however, its technical complexity and requirement for trained personnel limit its use in routine clinical and community settings. These challenges have driven the development of simplified techniques for population screening, such as brachial-ankle PWV (baPWV). More recently, single-cuff oscillometric devices have emerged as practical alternatives. These methods are simple enough to be implemented in daily healthcare at home, thereby greatly enhancing accessibility, although their accuracy depends on model assumptions and calibration. In this perspective article, we highlight the pathophysiological significance of preserving the central arterial Windkessel function and emphasize the need for its practical assessment. Recent innovations mark a paradigm shift from complex laboratory-based measurements toward simplified, data-driven, and socially feasible screening tools for the early detection and prevention of CVD.
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