Wave-intensity analysis: a new approach to coronary hemodynamics

Sun, Yi-Hui; Anderson, Todd J.; Parker, Kim H.; Tyberg, John V.

doi:10.1152/jappl.2000.89.4.1636

Cited by 104 publications

(116 citation statements)

References 28 publications

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“…[3] One of the main advantages of WIA is the application of this technique in conditions where distal resistance changes transiently during the analysis period, typically the cardiac cycle. For example, the technique of WIA has proven especially useful in the coronary circulation [20]. However, in a time-invariant system, similar results can be obtained with the frequency domain model [16,17].…”

Section: Wave Separation and Wave Intensity Analysismentioning

confidence: 84%

“…This method is especially useful for the study of non-periodic transient flow and flows where the load impedance of the system is varying strongly, e.g. during a heart cycle in the coronary arterial system [5,20,29]. Pressure and flow waves are assumed to travel in the forward direction with the sum of the wave speed, c, and the blood flow velocity, U, whereas the backward traveling waves are assumed to travel with the difference of the wave speed, and blood flow velocity, in the backward direction.…”

Section: Analysis Of Wave Intensitymentioning

confidence: 99%

“…and dU ? describing the intensity of the forward traveling wave and dP -dU -as the intensity of the backward traveling wave [20].…”

Section: Analysis Of Wave Intensitymentioning

confidence: 99%

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Comparison of arterial waves derived by classical wave separation and wave intensity analysis in a model of aortic coarctation

Wijngaard

Siebes

Westerhof

2008

Med Biol Eng Comput

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Coarctation of the aorta may develop during fetal life and impair quality of life in the adult because upper body hypertension and aneurysm formation in the descending aorta may develop. We used our computational model of the young adult arterial circulation, incorporated aorta coarctation over a range from 0 to 80% and evaluated the effects in terms of forward pressure (P ? ) and backward pressure (P -). Predictions at several sites proximal and distal to the coarctation using an impedance-based waveform separation method (WSA) and the time-domain technique of wave intensity analysis (WIA) yielded comparable outcomes. A large reflected backward compression wave was seen proximal to the coarctation. Both techniques, WSA and WIA, gave the same results in terms of P ? and P -. A descending index (DI) was formulated as the difference between peak systolic pressure and valve closure pressure, divided by the pulse pressure. DI increased with stenosis severity for mild to moderate aortic coarctations that did not yet cause evident hypertension. This index may allow for early diagnosis by noninvasive estimation of coarctation severity.

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Section: Wave Separation and Wave Intensity Analysismentioning

confidence: 84%

Section: Analysis Of Wave Intensitymentioning

confidence: 99%

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Comparison of arterial waves derived by classical wave separation and wave intensity analysis in a model of aortic coarctation

Wijngaard

Siebes

Westerhof

2008

Med Biol Eng Comput

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“…The most important one may be coronary blood flow. Sun et al [35,36] reported the results of wave intensity separation analysis in dogs, and Davies et al [7] reported those in humans.…”

Section: Separation Of Wave Intensity Into the Forward And Backward Cmentioning

confidence: 99%

Clinical usefulness of wave intensity analysis

Sugawara

Niki

Ohte

et al. 2008

Med Biol Eng Comput

100

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Wave intensity (WI) is a hemodynamic index, which can evaluate the working condition of the heart interacting with the arterial system. It can be defined at any site in the circulatory system and provides a great deal of information. However, we need simultaneous measurements of blood pressure and velocity to obtain wave intensity, which has limited the clinical application of wave intensity, in spite of its potential. To expand the application of wave intensity in the clinical setting, we developed a real-time non-invasive measurement system for wave intensity based on a combined color Doppler and echo-tracking system. We measured carotid arterial WI in normal subjects and patients with various cardiovascular diseases. In the coronary artery disease group, the magnitude of the first peak of carotid arterial WI (W 1 ) increased with LV max. dP/dt (r = 0.74, P \ 0.001), and the amplitude of the second peak (W 2 ) decreased with an increase in the time constant of LV pressure decay (r = -0.77, P \ 0.001). In the dilated cardiomyopathy group, the values of W 1 were much lower than those in the normal group (P \ 0.0001). In the hypertrophic cardiomyopathy group, the values of W 2 were much smaller than those in the normal group (P \ 0.0001). In mitral regurgitation before surgery, W 2 decreased or disappeared, but after surgery W 2 appeared clearly. In the hypertension group, the magnitude of reflection from the head was considerably greater than that in the normal group (P \ 0.0001). We also evaluated hemodynamic effects of sublingual nitroglycerin in normal subjects. Nitroglycerin increased W 1 significantly (P \ 0.001). WI can be obtained non-invasively using an echo-Doppler system in the clinical setting. This method will increase the clinical usefulness of wave intensity.

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“…Wave intensity analysis has also been applied to the coronary arteries [15], which is highly complicated, since in this circulatory system the waves not only travel from the aorta to the downstream coronary vascular bed but waves are also simultaneously generated by compression of the myocardial microcirculation and travel to the aorta. However, the coronary arteries are short in relation to wavelength which makes this vascular system rather more complicated to analyze than the aorta [4].…”

mentioning

confidence: 99%