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Published on: January 14, 2014
Beat-to-beat coronary wave intensity analysis: implications of backward waves originating from microvascular
Xinzhou Xie1, Peng Han2,3, Tiantong Yu2,4
1Department of Information Engineering, School of Electronics and Information, Northwestern Polytechnical University, Xi'an, Shaanxi, China.
Insights
This study introduces a simplified coronary wave intensity analysis (cWIA) method using angiography. The findings validate its clinical feasibility and clarify the impact of hemodynamic factors on cWIA parameters for better myocardial and microvascular assessment.
Area of Science:
- Cardiovascular Physiology
- Biomedical Engineering
- Diagnostic Imaging
Background:
- Coronary wave intensity analysis (cWIA) assesses myocardial and microvascular function by analyzing backward waves.
- Current cWIA methods face challenges due to complex data acquisition and unclear influences of hemodynamic factors like adenosine, stenosis, and vessel type.
Purpose of the Study:
- To introduce and validate an angiography-based cWIA method.
- To clarify the impact of hemodynamic factors (adenosine, stenosis, vessel type) on cWIA parameters.
- To support the clinical application of cWIA for assessing coronary function.
Main Methods:
- Retrospective study of 124 patients with 125 target vessels.
- Beat-to-beat cWIA performed at rest and during adenosine-induced hyperemia.
- Analysis of correlations between cWIA parameters (cBCW, cBDW, pBCW, pBDW) and hemodynamic conditions.
Main Results:
- Strong correlations found between cumulative backward compression wave intensity (cBCW) and cumulative backward decompression wave intensity (cBDW) in both resting and hyperemic states.
- Adenosine-induced hyperemia significantly increased cBCW and peak backward compression wave intensity (pBCW), while decreasing peak backward decompression wave intensity (pBDW).
- Neither stenotic lesions nor vessel type (LAD/RCA) significantly impacted quantitative parameters of microvascular backward waves.
Conclusions:
- An accessible, angiography-based cWIA method has been validated for clinical use.
- The study clarifies the influence of hemodynamic factors on cWIA parameters.
- Findings provide a strong basis for the broader clinical application of cWIA in cardiovascular diagnostics.
Introduction:
While coronary wave intensity analysis (cWIA) offers a promising way to assess myocardial and microvascular function by decomposing microvascular-originated backward waves, its clinical utility is currently limited by complex data acquisition and unclear influence of varying hemodynamic factors (adenosine, stenosis and vessel type).
Methods:
This study introduces an angiography-based cWIA method and clarifies how those hemodynamic factors impact cWIA parameters. This retrospective study included 124 patients with 125 target vessels, for which beat-to-beat cWIA was successfully performed at rest and during adenosine-induced hyperemia.
Results:
Our analysis revealed a strong and significant correlation between cumulative backward compression wave intensity (cBCW) and cumulative backward decompression wave intensity (cBDW) in both resting (rho = 0.846, 95%CI: 0.786 to 0.891, p < 0.001) and hyperemic states (rho = 0.768, 95%CI: 0.681 to 0.833, p < 0.001). Compared to rest, adenosine-induced hyperemia significantly increased cBCW (1.88 ± 1.46 ×104 W/m2s vs. 2.31 ± 1.74 × 104 W/m2s, p < 0.001) and peak backward compression wave intensity (pBCW) (4.30 ± 4.61 ×105 W/m2s2 vs. 5.21 ± 4.68 × 105 W/m2s2, p = 0.008), while significantly decreasing peak backward decompression wave intensity (pBDW) (5.41 ± 6.06 × 105 W/m2s2 vs. 3.99 ± 4.64 × 105 W/m2s2, p < 0.001), with no significant effect on cBDW. Neither functional stenotic lesions nor vessel type [left anterior descending coronary artery (LAD) or right coronary artery (RCA)] significantly impacted quantitative parameters of the microvascular-originated backward waves.
Discussion:
The clinical feasibility of a convenient cWIA method was validated, and the impact of various hemodynamic factors on quantitative parameters of cWIA were analyzed, providing strong support for the clinical application of cWIA.
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