Kim H. Parker edited textbf_C7_The_recent_paper__.tex  almost 9 years ago

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\textbf{[C7].} The recent paper by Segers et al. warrants further study. A concern, particularly in the light of the factual errors in the WSW paper, is whether or not the reservoir pressure they use is the same reservoir pressure we have defined or another error-based reservoir pressure. We find that deriving Pr from clinically measured P is not easy and have spent considerable time in producing an algorithm that robustly calculates a physically reasonable Pr from clinical pressure waveforms. A basic problem is that we have no way of knowing the 'true' reservoir pressure in patients. Similarly, because we do not yet have a universally agreed theory of the reservoir pressure, this is also true for pressure waveforms generated by numerical models where the parameters are known. All models that we are aware of contain compliances in the vessels, in the boundary conditions at the end of the terminal vessels and occasionally in the input conditions at the left ventricle in the guise of elastance. Much further work on the theoretical basis of PR is needed.  \textbf{[C8].} We agree that the reference to Womersley44 in Davies et al.20 is not helpful because it does not deal with the case of a bifurcating tree of arteries, except to point out that 'When a number of junctions are cascaded in series, the direct method of calculation becomes clumsy and   tedious...'. A better reference would be to Wormersley's comment reported in the 2nd edition of Blood Flow in Arteries, by MacDonald ''.    \textbf{[C9].} This comment propagates the error that $P_{res} = 2P^b$ discussed above. Reiterating our belief that the reservoir pressure is dominated by the global properties of the arterial system and excess pressure is dominated by local, we believe that it is interesting that most of changes in the arterial waveform found with aging. Since the reservoir pressure is the summation of many waves, both forward and backward, This does not imply that changes in reflections are not important. Since $P_{res}$ is not directly related to $P^b$ during systole, the observations in Davies et al. provide an alternative view of the effects of aging on global and local arterial properties.