Artery Research

Volume 12, Issue C, December 2015, Pages 4 - 4

P1.4 HEMODYNAMICS OF PULMONARY HYPERTENSION: APPLICATION OF THE RESERVOIR-WAVE APPROACH

Authors
Anukul Ghimire*1, Mads Andersen2, 3, Lindsay Burrowes1, J. Christopher Bouwmeester4, Andrew Grant1, Israel Belenkie1, Nowell Fine1, Barry Borlaug3, John Tyberg1
1University of Calgary, Calgary, Alberta, Canada
2Aarhus University Hospital, Aarhus, Denmark
3Mayo Clinic, Rochester, MN, USA
4Yale University, New Haven, CT, USA
Available Online 23 November 2015.
DOI
https://doi.org/10.1016/j.artres.2015.10.198How to use a DOI?
Abstract

Using the reservoir-wave approach, previously we characterized pulmonary vasculature mechanics with multiple interventions in a canine model. In the present study, we measured high-fidelity pulmonary arterial (PA) pressure, Doppler flow velocity, and pulmonary capillary wedge pressure in 11 patients referred for evaluation of exertional dyspnea. The analysis was performed using the reservoir-wave approach; wave intensity analysis was subsequently utilized to characterize the PA wave pattern. Our objective was to identify specific abnormalities associated with pulmonary hypertension.

Seven patients with varying PA pressures had reduced pulmonary vascular conductance (i.e., the amount of flow that the lungs can accept per pressure gradient), suggesting that these patients might benefit from pulmonary vasodilator therapy, some even in the absence of markedly elevated PA pressures.

Right ventricular (RV) performance was assessed by examining the work done by the wave component of systolic PA pressure. Wave work, the non-recoverable energy expended by the RV to eject blood, varied directly with mean PA pressure. Wave pressure was partitioned into two components: forward-travelling and reflected backward-travelling waves. Among patients with lower PA pressures, we found pressure-decreasing backward waves that aided the RV during ejection, as previously reported in normal experimental animals. Among patients with higher PA pressures, we detected pressure-increasing backward waves that impede RV ejection.

We conclude that it is important to measure pulmonary vascular conductance to properly assess the pulmonary vasculature. The reservoir-wave approach and wave intensity analysis may prove to be valuable tools to evaluate RV performance and may facilitate development of therapeutic strategies.

Open Access
This is an open access article distributed under the CC BY-NC license.

Journal
Artery Research
Volume-Issue
12 - C
Pages
4 - 4
Publication Date
2015/11
ISSN (Online)
1876-4401
ISSN (Print)
1872-9312
DOI
https://doi.org/10.1016/j.artres.2015.10.198How to use a DOI?
Open Access
This is an open access article distributed under the CC BY-NC license.

Cite this article

TY  - JOUR
AU  - Anukul Ghimire*
AU  - Mads Andersen
AU  - Lindsay Burrowes
AU  - J. Christopher Bouwmeester
AU  - Andrew Grant
AU  - Israel Belenkie
AU  - Nowell Fine
AU  - Barry Borlaug
AU  - John Tyberg
PY  - 2015
DA  - 2015/11
TI  - P1.4 HEMODYNAMICS OF PULMONARY HYPERTENSION: APPLICATION OF THE RESERVOIR-WAVE APPROACH
JO  - Artery Research
SP  - 4
EP  - 4
VL  - 12
IS  - C
SN  - 1876-4401
UR  - https://doi.org/10.1016/j.artres.2015.10.198
DO  - https://doi.org/10.1016/j.artres.2015.10.198
ID  - Ghimire*2015
ER  -