Pressure-flow distinction in cardiovascular assessment

Pressure-flow distinction in cardiovascular assessment is the separation of blood pressure, a mechanical loading quantity, from blood flow, a volume transported per unit time. Cardiac output is a flow rate. A pressure reading alone does not specify the volume of blood delivered by the heart.

In a simplified steady model,where $\Delta p$ is the pressure difference across the represented vascular region, $Q$ is its blood flow and $R$ its effective vascular resistance. The difference between upstream and downstream blood pressure matters, rather than one pressure considered in isolation. The pressure-gradient and resistance account is developed in the primary physiology text.^[ref]

An original counterexample holds the pressure difference fixed at 90 mmHg. With $R=18$ mmHg/(L/min), flow is 5 L/min; with $R=30$ mmHg/(L/min), flow is 3 L/min. The same driving pressure can accompany different delivery rates. Conversely, at fixed flow a higher measured pressure difference can represent a higher effective resistance.

The quantities also have different dimensions. The product $\Delta pQ$ has units of energy per time, describing a hydraulic rate of mechanical energy transfer in this model. A pressure alone has neither flow units nor power units.

A primary coronary thermodilution apparatus combined a pressure/temperature-sensing guidewire with a controlled infusion catheter; its flow estimate used infusion rate and temperature measurements.^[ref] The availability of pressure and thermal signals in one instrument does not make them the same observable. Finally, pulsatile circulation includes storage and changing vessel geometry, so the steady resistance relation is an explanatory approximation. Matching time averages, anatomical sites and model assumptions is part of interpreting pressure and flow together.