scholarly journals Estimation of Pulmonary Arterial Wave Reflection by Echo-Doppler: A Preliminary Study in Dogs With Experimentally-Induced Acute Pulmonary Embolism

2021 ◽  
Vol 12 ◽  
Author(s):  
Tomohiko Yoshida ◽  
Tokuhisa Uejima ◽  
Syunta Komeda ◽  
Katsuhiro Matsuura ◽  
Akiko Uemura ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Wave Reflection ◽  
Right Ventricular Outflow Tract ◽  
Limits Of Agreement ◽  
Pulmonary Hemodynamics ◽  
Flow Measurements ◽  
Ventricular Afterload ◽  
Dual Sensor ◽  
Pulmonary Arterial ◽  
Flow Waveforms

Background: Pulmonary arterial (PA) wave reflection provides additional information for assessing right ventricular afterload, but its applications is hampered by the need for invasive pressure and flow measurements. We tested the hypothesis that PA pressure and flow waveforms estimated by Doppler echocardiography could be used to quantify PA wave reflection.Methods: Doppler echocardiographic images of tricuspid regurgitation and right ventricular outflow tract flow used to estimate PA pressure and flow waveforms were acquired simultaneously with direct measurements with a dual sensor-tipped catheter under various hemodynamic conditions in a canine model of pulmonary hypertension (n = 8). Wave separation analysis was performed on echo-Doppler derived as well as catheter derived waveforms to separate PA pressure into forward (Pf) and backward (Pb) pressures and derive wave reflection coefficient (RC) defined as the ratio of peak Pb to peak Pf.Results: Wave reflection indices by echo-Doppler agreed well with corresponding indices by catheter (Pb: mean difference = 0.4 mmHg, 95% limits of agreement = −4.3 to 5.0 mmHg; RC: bias = 0.13, 95% limits of agreement = −0.25 to 0.26). RC correlated negatively with PA compliance.Conclusion: This echo-Doppler method yields reasonable measurement of reflected wave in the pulmonary circulation, paving the way to a more integrative assessment of pulmonary hemodynamics in the clinical setting.

scholarly journals A New Echo-Doppler Method of Assessing Pulmonary Arterial Wave Reflection: In Vivo Validation

2021 ◽  
Author(s):  
Tomohiko Yoshida ◽  
Tokuhisa Uejima ◽  
Syunta Komeda ◽  
Katsuhiro Matsuura ◽  
Akiko Uemura ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Wave Reflection ◽  
Arterial Compliance ◽  
Right Ventricular Outflow Tract ◽  
Pulmonary Hemodynamics ◽  
Flow Measurements ◽  
Doppler Method ◽  
Dual Sensor ◽  
Pulmonary Arterial ◽  
Flow Waveforms

Abstract Background: Pulmonary arterial (PA) wave reflection provides additional information for assessing right ventricular afterload, but its applications is hampered by the need for invasive pressure and flow measurements. We tested the hypothesis that PA pressure and flow waveforms estimated by Doppler echocardiography could be used to quantify PA wave reflection. Methods: Doppler echocardiographic images of tricuspid regurgitation and right ventricular outflow tract flow used to estimate PA pressure and flow waveforms were acquired simultaneously with direct measurements with a dual sensor-tipped catheter under various hemodynamic conditions in a canine model of pulmonary hypertension (n=8). Wave separation analysis was performed on echo-Doppler derived as well as catheter derived waveforms to separate PA pressure into forward (Pf) and backward (Pb) pressures and derive wave reflection coefficient (RC) defined as Pb divided by Pf.Results: RC by echo-Doppler agreed well with RC indices by catheter (RC: bias = 0.13, 95% limits of agreement = -0.25 to 0.26). RC correlated negatively with pulmonary arterial compliance and right ventricular systolic function. Conclusions: This echo-Doppler method yields accurate measurement of reflected wave in the pulmonary circulation, paving the way to a more integrative assessment of pulmonary hemodynamics in the clinical setting.

Effect of perivascular electromagnetic flow probes on pulmonary hemodynamics

1988 ◽  
Vol 65 (4) ◽  
pp. 1885-1890 ◽  
Author(s):  
B. J. Grant ◽  
L. J. Paradowski ◽  
J. M. Fitzpatrick
Keyword(s):  
Right Ventricular ◽  
Input Impedance ◽  
Diastolic Pressure ◽  
Main Pulmonary Artery ◽  
Systemic Blood Pressure ◽  
Pulmonary Hemodynamics ◽  
Electromagnetic Flow ◽  
Ventricular Afterload ◽  
Significant Difference ◽  
Pulmonary Arterial

We determined the effect of perivascular electromagnetic flow probes (EMF) on pulmonary hemodynamics in acute experiments. In seven dogs placement of the EMF on the main pulmonary artery (MPA) increased pulmonary arterial pulse pressure by 25% (17.8-21.9 cmH2O, P less than 0.005) and mean right ventricular pressure by 12% (23.2-25.9 cmH2O, P less than 0.001) but did not alter heart rate, systemic blood pressure, mean pulmonary arterial pressure, or right ventricular end-diastolic pressure. This response was not abolished by local application of lidocaine to the MPA. In three cats input impedance was calculated from measurements of pressure and flow in the MPA. Impedance was calculated with flow measured using an EMF and ultrasonic volume flow probe (USF), which avoids the constraining effect of the EMF. When flow was measured with an EMF rather than a USF, there was a significant difference in the impedance spectra (P less than 0.001), but it was only apparent in the moduli greater than six harmonics. We conclude that the EMF does affect right ventricular afterload in acute experiments and alters the measured input impedance.

The Influence of Pulmonary Hemodynamics on Right Ventricular Function in Pulmonary Hypertension

2013 ◽  
Author(s):  
Vitaly O. Kheyfets ◽  
Lourdes Rios ◽  
Triston Smith ◽  
Theodore Schroeder ◽  
Jeffrey Mueller ◽  
...  
Keyword(s):  
Fluid Dynamics ◽  
Pulmonary Hypertension ◽  
Shear Stress ◽  
Right Ventricular ◽  
Pulmonary Arteries ◽  
Pulmonary Hemodynamics ◽  
Arterial Hemodynamics ◽  
Computational Fluid Dynamics Cfd ◽  
Pulmonary Arterial ◽  
Rv Function

Pulmonary arterial hypertension (PAH) is a degenerative disease that can lead to substantial morphometric remodeling of the pulmonary arteries. Previous studies have revealed coupling relationships between right ventricular (RV) function and pulmonary arterial hemodynamics. The objective of this study was to utilize computational fluid dynamics (CFD) to estimate spatially averaged Wall Shear Stress (WSS) for patients with PH and explore correlations between hemodynamics metrics and RV function.

Proximal pulmonary arterial obstruction decreases the time constant of the pulmonary circulation and increases right ventricular afterload

2013 ◽  
Vol 114 (11) ◽  
pp. 1586-1592 ◽  
Author(s):  
Alberto Pagnamenta ◽  
Rebecca Vanderpool ◽  
Serge Brimioulle ◽  
Robert Naeije
Keyword(s):  
Pulmonary Hypertension ◽  
Right Ventricular ◽  
Time Constant ◽  
Pulse Pressure ◽  
Pulmonary Circulation ◽  
Characteristic Impedance ◽  
Ventricular Afterload ◽  
Hydraulic Load ◽  
Distal Obstruction ◽  
Pulmonary Arterial

The time constant of the pulmonary circulation, or product of pulmonary vascular resistance (PVR) and compliance (Ca), called the RC-time, has been reported to remain constant over a wide range of pressures, etiologies of pulmonary hypertension, and treatments. We wondered if increased wave reflection on proximal pulmonary vascular obstruction, like in operable chronic thromboembolic pulmonary hypertension, might also decrease the RC-time and thereby increase pulse pressure and right ventricular afterload. Pulmonary hypertension of variable severity was induced either by proximal obstruction (pulmonary arterial ensnarement) or distal obstruction (microembolism) eight anesthetized dogs. Pulmonary arterial pressures (Ppa) were measured with high-fidelity micromanometer-tipped catheters, and pulmonary flow with transonic technology. Pulmonary ensnarement increased mean Ppa, PVR, and characteristic impedance, decreased Ca and the RC-time (from 0.46 ± 0.07 to 0.30 ± 0.03 s), and increased the oscillatory component of hydraulic load (Wosc/Wtot) from 25 ± 2 to 29 ± 2%. Pulmonary microembolism increased mean Ppa and PVR, with no significant change in Ca and characteristic impedance, increased RC-time from 0.53 ± 0.09 to 0.74 ± 0.05 s, and decreased Wosc/Wtot from 26 ± 2 to 13 ± 2%. Pulse pressure increased more after pulmonary ensnarement than after microembolism. Concomitant measurements with fluid-filled catheters showed the same functional differences between the two types of pulmonary hypertension, with, however, an underestimation of Wosc. We conclude that pulmonary hypertension caused by proximal vs. distal obstruction is associated with a decreased RC-time and increased pulsatile component of right ventricular hydraulic load.

Right Ventricular Pressure Waveform and Wave Reflection Analysis in Patients With Pulmonary Arterial Hypertension

CHEST Journal ◽  
2007 ◽  
Vol 132 (1) ◽  
pp. 37-43 ◽  
Author(s):  
Mustafa Karamanoglu ◽  
Michael McGoon ◽  
Robert P. Frantz ◽  
Raymond L. Benza ◽  
Robert C. Bourge ◽  
...  
Keyword(s):  
Pulmonary Arterial Hypertension ◽  
Arterial Hypertension ◽  
Right Ventricular ◽  
Wave Reflection ◽  
Ventricular Pressure ◽  
Pressure Waveform ◽  
Pulmonary Arterial

Development of right ventricular outflow tract obstruction after double-lung transplantation for primary pulmonary hypertension

1995 ◽  
Vol 5 (3) ◽  
pp. 278-281 ◽  
Author(s):  
Gül Sagin Saylam ◽  
Jane Somerville
Keyword(s):  
Pulmonary Hypertension ◽  
Lung Transplantation ◽  
Right Ventricular ◽  
Primary Pulmonary Hypertension ◽  
Pulmonary Arterial Pressure ◽  
Right Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Outflow Tract ◽  
Pulmonary Arterial ◽  
The Right

SummaryWe present a patient with primary pulmonary hypertension who had unusually high pulmonary arterial pressure prior to double-lung transplantation. Obstruction of the right ventricular outflow tract developed after transplantation and progressed over the subsequent two years.

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