When performing a carotid to femoral PWV measurement, why do we subtract the carotid-sternum distance from the sternum-femoralis distance to get the total distance travelled by the pulse?
“The proximal and distal pulse waves may be recorded from two different arterial sites, where pulse waves propagate in opposite directions, such as for the carotid-femoral PWV measurement. In fact, the pulse wave generated by the left ventricle contraction is propagated throughout the aorta, iliac and femoral arteries in the opposite direction than through the carotid artery. In this case, evaluating the covered distance by superficial measurement … presents some margin of error..” (Ref) In other words, using the superficially measured carotid to femoral distance to calculate PWV will produce an error because of the opposite direction of the pulse propagation of both arterial sites. To compensate for that, you need to subtract the carotid-sternum distance from the sternum-femoralis distance and use the result as the distance for calculating PWV. Ref: Asmar R, “Arterial Stiffness and Pulse Wave Velocity: Clinical Applications”, 1999 Editions scientifiques et medicals Elsevier SAS, 199
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