Fig. 1.

Hemodynamic impact of arterial stiffness gradient. a In normal condition, aortic stiffness is lower than that of medium-sized conduit arteries, creating wave reflections and therefore attenuating pulse pressure transmission to the circulation. b When aortic stiffness increases with minimal changes of stiffness in medium-sized conduit arteries, the forward pressure wave is less attenuated (i.e. there is less reflection), therefore the forward pulse wave is transmitted to the microcirculation stimulating myogenic response and enhanced wave reflection from the microcirculation. This condition could potentially lead to hypoperfusion and organ dysfunction. Reprinted from Briet et al. [9] with permission.