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Incremental changes of arterial blood pressure are determined by forward and backward waves, originated from the heart and from the periphery, respectively. The reservoir-wave theory assumes that the measured pressure consists of two additive components: reservoir (Pr) and “excess” pressure (Pex). This approach was successfully applied by Wang et al. [1] in canine aorta and for the calculation of venous reservoir [2]; then it was extended to any arbitrary arterial location [3,4]. Great differences of clinical and physiological hemodynamic relevant parameters, particularly the size of reflected waves, were reported in a comparison of wave speed and wave intensity analysis determined with and without the reservoir-wave approach [5]. The calculation of Pr requires fitting the diastolic decay of the measured pressure waveform to determine P∞ (asymptotical value) and b (time constant) and there is no consensus over either the value of these parameters or the fitting method for their quantification. Some researchers decided not to fit P∞ but kept it fixed. Specifically, Aguado-Sierra et al. [3] fixed P∞ = 0 mmHg for experimental data and P∞ = 3.2 mmHg (432.6 Pa) for computational data, following Wang et al. [2], who suggested that the asymptotical value is affected by the waterfall effect. Vermeersch et al. [6] calculated the reservoir pressure in the Asklepios population following AguadoSierra et al. [3]; however, they found non-physiological values of P∞ with free-fitting and decided to set the asymptotical value to 0 for the entire dataset. A successive study conducted by Aguado-Sierra et al. [4] on human subjects used the same framework but imposed P∞ = 25 mmHg, based on previous work of Schipke et al. [7], who determined the arterial asymptotical value in anesthetized humans under fibrillation/defibrillation sequences.

Implications of Changing the Asymptotic Diastolic Pressure in the Reservoir-wave Model on Wave Intensity Parameters: A Parametric Study