scholarly journals Wave Intensity Analysis in the Human Coronary Circulation in Health and Disease

2014 ◽  
Vol 10 (1) ◽  
pp. 17-23 ◽  
Author(s):  
Sayan Sen ◽  
Ricardo Petraco ◽  
Jamil Mayet ◽  
Justin Davies
Keyword(s):  
Coronary Circulation ◽  
Wave Intensity ◽  
Intensity Analysis ◽  
Wave Intensity Analysis ◽  
Health And Disease

scholarly journals Estimation of coronary wave intensity analysis using noninvasive techniques and its application to exercise physiology

2016 ◽  
Vol 310 (5) ◽  
pp. H619-H627 ◽  
Author(s):  
Christopher J. Broyd ◽  
Sukhjinder Nijjer ◽  
Sayan Sen ◽  
Ricardo Petraco ◽  
Siana Jones ◽  
...  
Keyword(s):  
Coronary Circulation ◽  
Exercise Physiology ◽  
Left Ventricular ◽  
Wave Intensity ◽  
Concordance Correlation Coefficient ◽  
Intensity Analysis ◽  
Wave Intensity Analysis ◽  
Concordance Correlation ◽  
Decompression Wave ◽  
Pulsed Wave Doppler

Wave intensity analysis (WIA) has found particular applicability in the coronary circulation where it can quantify traveling waves that accelerate and decelerate blood flow. The most important wave for the regulation of flow is the backward-traveling decompression wave (BDW). Coronary WIA has hitherto always been calculated from invasive measures of pressure and flow. However, recently it has become feasible to obtain estimates of these waveforms noninvasively. In this study we set out to assess the agreement between invasive and noninvasive coronary WIA at rest and measure the effect of exercise. Twenty-two patients (mean age 60) with unobstructed coronaries underwent invasive WIA in the left anterior descending artery (LAD). Immediately afterwards, noninvasive LAD flow and pressure were recorded and WIA calculated from pulsed-wave Doppler coronary flow velocity and central blood pressure waveforms measured using a cuff-based technique. Nine of these patients underwent noninvasive coronary WIA assessment during exercise. A pattern of six waves were observed in both modalities. The BDW was similar between invasive and noninvasive measures [peak: 14.9 ± 7.8 vs. −13.8 ± 7.1 × 104 W·m−2·s−2, concordance correlation coefficient (CCC): 0.73, P < 0.01; cumulative: −64.4 ± 32.8 vs. −59.4 ± 34.2 × 102 W·m−2·s−1, CCC: 0.66, P < 0.01], but smaller waves were underestimated noninvasively. Increased left ventricular mass correlated with a decreased noninvasive BDW fraction ( r = −0.48, P = 0.02). Exercise increased the BDW: at maximum exercise peak BDW was −47.0 ± 29.5 × 104 W·m−2·s−2 ( P < 0.01 vs. rest) and cumulative BDW −19.2 ± 12.6 × 103 W·m−2·s−1 ( P < 0.01 vs. rest). The BDW can be measured noninvasively with acceptable reliably potentially simplifying assessments and increasing the applicability of coronary WIA.

scholarly journals Wave intensity analysis and its application to the coronary circulation

2017 ◽  
Vol 2017 (1) ◽  
Author(s):  
C J Broyd ◽  
J E Davies ◽  
J E Escaned ◽  
A Hughes ◽  
K Parker
Keyword(s):  
Coronary Artery ◽  
Coronary Circulation ◽  
Spatial Location ◽  
Left Ventricular ◽  
Wave Intensity ◽  
Intensity Analysis ◽  
Wave Intensity Analysis ◽  
Decompression Wave ◽  
Artery Disease ◽  
Incident Waves

Wave intensity analysis (WIA) is a technique developed from the field of gas dynamics that is now being applied to assess cardiovascular physiology. It allows quantification of the forces acting to alter flow and pressure within a fluid system, and as such it is highly insightful in ascribing cause to dynamic blood pressure or velocity changes.When co-incident waves arrive at the same spatial location they exert either counteracting or summative effects on flow and pressure. WIA however allows waves of different origins to be measured uninfluenced by other simultaneously arriving waves. It therefore has found particular applicability within the coronary circulation where both proximal (aortic) and distal (myocardial) ends of the coronary artery can markedly influence blood flow. Using these concepts, a repeating pattern of 6 waves has been consistently identified within the coronary arteries, 3 originating proximally and 3 distally. Each has been associated with a particular part of the cardiac cycle. The most clinically relevant wave to date is the backward decompression wave, which causes the marked increase in coronary flow velocity observed at the start of the diastole. It has been proposed that this wave is generated by the elastic re-expansion of the intra-myocardial blood vessels that are compressed during systolic contraction. Particularly by quantifying this wave, WIA has been used to provide mechanistic and prognostic insight into a number of conditions including aortic stenosis, left ventricular hypertrophy, coronary artery disease and heart failure. It has proven itself to be highly sensitive and as such a number of novel research directions are encouraged where further insights would be beneficial. 

O155 Wave Intensity Analysis of the Pulmonary Circulation in Health and DIsease

Global Heart ◽  
2014 ◽  
Vol 9 (1) ◽  
pp. e42
Author(s):  
Edmund Lau ◽  
Kaipa T. Srinivas ◽  
David Abelson ◽  
Nathan Dwyer ◽  
Martin Ng ◽  
...  
Keyword(s):  
Pulmonary Circulation ◽  
Wave Intensity ◽  
Intensity Analysis ◽  
Wave Intensity Analysis ◽  
Health And Disease

scholarly journals Wave intensity analysis and its application to the coronary circulation

2015 ◽  
Vol 2015 (5) ◽  
pp. 64 ◽  
Author(s):  
C.J. Broyd ◽  
J.E. Davies ◽  
J.E. Escaned ◽  
A. Hughes ◽  
K Parker
Keyword(s):  
Coronary Circulation ◽  
Wave Intensity ◽  
Intensity Analysis ◽  
Wave Intensity Analysis

Wave intensity analysis of left atrial mechanics and energetics in anesthetized dogs

2007 ◽  
Vol 292 (3) ◽  
pp. H1533-H1540 ◽  
Author(s):  
Tracy N. Hobson ◽  
Jacqueline A. Flewitt ◽  
Israel Belenkie ◽  
John V. Tyberg
Keyword(s):  
Mitral Valve ◽  
Pulmonary Veins ◽  
Left Ventricular ◽  
Wave Intensity ◽  
Intensity Analysis ◽  
Wave Intensity Analysis ◽  
Volume Loading ◽  
Forward Movement ◽  
Reflected Wave ◽  
Left Atrial Mechanics

The left atrium (LA) acts as a booster pump during late diastole, generating the Doppler transmitral A wave and contributing incrementally to left ventricular (LV) filling. However, after volume loading and in certain disease states, LA contraction fills the LV less effectively, and retrograde flow (i.e., the Doppler Ar wave) into the pulmonary veins increases. The purpose of this study was to provide an energetic analysis of LA contraction to clarify the mechanisms responsible for changes in forward and backward flow. Wave intensity analysis was performed at the mitral valve and a pulmonary vein orifice. As operative LV stiffness increased with progressive volume loading, the reflection coefficient (i.e., energy of reflected wave/energy of incident wave) also increased. This reflected wave decelerated the forward movement of blood through the mitral valve and was transmitted through the LA, accelerating retrograde blood flow in the pulmonary veins. Although total LA work increased with volume loading, the forward hydraulic work decreased and backward hydraulic work increased. Thus wave reflection due to increased LV stiffness accounts for the decrease in the A wave and the increase in the Ar wave measured by Doppler.

Wave intensity analysis and the development of the reservoir–wave approach

2009 ◽  
Vol 47 (2) ◽  
pp. 221-232 ◽  
Author(s):  
John V. Tyberg ◽  
Justin E. Davies ◽  
Zhibin Wang ◽  
William A. Whitelaw ◽  
Jacqueline A. Flewitt ◽  
...  
Keyword(s):  
Wave Intensity ◽  
Intensity Analysis ◽  
Wave Intensity Analysis ◽  
Wave Approach

Wave speed in human coronary arteries is not influenced by microvascular vasodilation: implications for wave intensity analysis

2014 ◽  
Vol 109 (2) ◽  
Author(s):  
M. Cristina Rolandi ◽  
Kalpa Silva ◽  
Matthew Lumley ◽  
Timothy P. E. Lockie ◽  
Brian Clapp ◽  
...  
Keyword(s):  
Coronary Arteries ◽  
Wave Speed ◽  
Wave Intensity ◽  
Intensity Analysis ◽  
Wave Intensity Analysis

scholarly journals Development and Validation of a New Adenosine-Independent Index of Stenosis Severity From Coronary Wave–Intensity Analysis

2012 ◽  
Vol 59 (15) ◽  
pp. 1392-1402 ◽  
Author(s):  
Sayan Sen ◽  
Javier Escaned ◽  
Iqbal S. Malik ◽  
Ghada W. Mikhail ◽  
Rodney A. Foale ◽  
...  
Keyword(s):  
Wave Intensity ◽  
Intensity Analysis ◽  
Wave Intensity Analysis ◽  
Stenosis Severity ◽  
Development And Validation
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