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Diagnostic Value of the First Derivative of the Arterial Pressure Pulse in Aortic Valve Disease and in Hypertrophic Subaortic Stenosis.

Dean T. Mason, M.D.; and Eugene Braunwald, M.D., F.A.C.P.
Ann Intern Med. 1964;61(4):801. doi:10.7326/0003-4819-61-4-801_2
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Since the rate at which systemic arterial pressure rises is determined in part by the instantaneous velocity of left ventricular ejection, it was thought that determination of the rate of change of arterial pressure (dp/dt) might be of diagnostic value in patients with various forms of obstruction to left ventricular outflow. Arterial dp/dt was continuoulsy computed by means of an electronic differentiating circuit. To avoid the artifacts inherent in pressures measured by conventional systems, brachial artery tracings were obtained by puncture with a needle attached directly to a pressure transducer without intervening tubing. The peak dp/dt averaged 1091 ± 66


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