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Wave intensity analysis and its application to the coronary circulation.

Broyd, CJ; Davies, JE; Escaned, JE; Hughes, A; Parker, K; (2017) Wave intensity analysis and its application to the coronary circulation. Glob Cardiol Sci Pract , 2017 (1) , Article e201705. 10.21542/gcsp.2017.5. Green open access

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Abstract

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.

Type: Article
Title: Wave intensity analysis and its application to the coronary circulation.
Location: Qatar
Open access status: An open access version is available from UCL Discovery
DOI: 10.21542/gcsp.2017.5
Publisher version: http://dx.doi.org/10.21542/gcsp.2017.5
Language: English
Additional information: This work is licensed under a Creative Commons Attribution 4.0 International License.
Keywords: Wave intensity analysis, coronary vessels, diagnostic techniques, microcirculation, physiology
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science > Population Science and Experimental Medicine
URI: https://discovery.ucl.ac.uk/id/eprint/10048025
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