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Wave intensity analysis and its application to the coronary circulation.

C J Broyd1,2, J E Davies1, J E Escaned2

  • 1Imperial College London, London, UK.

Global Cardiology Science & Practice
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Summary

Wave intensity analysis (WIA) quantifies cardiovascular forces, revealing distinct wave patterns in coronary arteries. This technique offers insights into conditions like heart failure by analyzing the backward decompression wave during diastole.

Keywords:
Wave intensity analysiscoronary vesselsdiagnostic techniquesmicrocirculationphysiology

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Area of Science:

  • Cardiovascular Physiology
  • Fluid Dynamics
  • Biomedical Engineering

Background:

  • Wave intensity analysis (WIA), adapted from gas dynamics, quantifies forces influencing flow and pressure in fluid systems.
  • It enables the isolation and measurement of individual waves, overcoming interference from simultaneously arriving waves.
  • WIA is particularly valuable in the coronary circulation due to complex wave interactions from proximal and distal sources.

Purpose of the Study:

  • To apply wave intensity analysis (WIA) to assess cardiovascular physiology, specifically within the coronary circulation.
  • To elucidate the role of distinct pressure and flow waves in regulating coronary blood flow.
  • To investigate the potential of WIA in providing mechanistic and prognostic insights into cardiovascular diseases.

Main Methods:

  • Utilized wave intensity analysis (WIA) to measure pressure and flow dynamics.
  • Identified and analyzed a consistent pattern of six waves (three proximal, three distal) in the coronary arteries.
  • Focused on quantifying the backward decompression wave and its association with diastolic coronary flow.

Main Results:

  • A repeating pattern of six waves, originating from both proximal and distal sources, was consistently identified in the coronary arteries.
  • The backward decompression wave, occurring at the onset of diastole, was identified as a key determinant of increased coronary flow velocity.
  • WIA demonstrated high sensitivity in providing insights into cardiovascular conditions.

Conclusions:

  • Wave intensity analysis (WIA) is a powerful tool for understanding cardiovascular dynamics, particularly in the coronary circulation.
  • The identified wave patterns, especially the backward decompression wave, offer mechanistic explanations for physiological events like diastolic flow augmentation.
  • WIA has demonstrated significant potential for providing mechanistic and prognostic insights into various cardiovascular diseases, including aortic stenosis, left ventricular hypertrophy, coronary artery disease, and heart failure, encouraging further research.