Artery Research

Volume 12, Issue C, December 2015, Pages 35 - 35

P8.2 ARTERIAL WAVE REFLECTIONS: LOOKING BEYOND THE FIRST HARMONIC AND PRESSURE INFLECTION POINTS TO ASSESS LATE-SYSTOLIC VENTRICULAR LOADING

Authors
Timothy Phan*1, John Li1, Zoubair Ahmed3, Ejaz Shah2, Vandan Panchal2, Julio Chirinos2
1Rutgers University, Piscataway, NJ, USA
2University of Pennsylvania, Philadelphia, PA, USA
3Philadelphia VA Medical Center, Philadelphia, PA, USA
Available Online 23 November 2015.
DOI
10.1016/j.artres.2015.10.325How to use a DOI?
Abstract

Background: Late-systolic ventricular loading is associated with impaired relaxation and adverse remodeling. Standard indices of relative wave reflections such as augmentation index (AIx) and reflection magnitude (RM) from wave separation analysis blend different times within the cardiac cycle and are unspecific to their loading in late-systole. We introduce an index of late-systolic load (QfQrep), derived from wave transmission theory that integrates increased and earlier reflections specifically during late-systole while inherently normalized to the associated flow wave.

Methods: Central pressure and flow were measured in 226 subjects using carotid tonometry and phase-contrast MRI, respectively. AIx and RM were determined using standard methods. Reflected wave transit time (RWTTTUBE) was determined using tube-load modeling.

Results: Decreased RWTTTUBE (standardized β=−0.525; P<0.001) and increased RM (β=0.629; P<0.001) were significantly associated with QfQrep (R2=0.791).

Conclusion: QfQrep is strongly predicted by wave reflection timing and two standard wave reflection indices. RM is defined by the amplitude of the composite backward wave normalized by that of the composite forward wave, both of which occur at different times. AIx, also blending two different times, combines an early-systolic inflection point with a generally late-systolic pressure peak. The advantage of QfQrep is that it focuses on the reduced-ejection period to integrate effects of increased and earlier effects of reflections in late-systole. QfQrep can be obtained readily from standard wave separation analysis.

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Journal
Artery Research
Volume-Issue
12 - C
Pages
35 - 35
Publication Date
2015/11/23
ISSN (Online)
1876-4401
ISSN (Print)
1872-9312
DOI
10.1016/j.artres.2015.10.325How 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  - Timothy Phan*
AU  - John Li
AU  - Zoubair Ahmed
AU  - Ejaz Shah
AU  - Vandan Panchal
AU  - Julio Chirinos
PY  - 2015
DA  - 2015/11/23
TI  - P8.2 ARTERIAL WAVE REFLECTIONS: LOOKING BEYOND THE FIRST HARMONIC AND PRESSURE INFLECTION POINTS TO ASSESS LATE-SYSTOLIC VENTRICULAR LOADING
JO  - Artery Research
SP  - 35
EP  - 35
VL  - 12
IS  - C
SN  - 1876-4401
UR  - https://doi.org/10.1016/j.artres.2015.10.325
DO  - 10.1016/j.artres.2015.10.325
ID  - Phan*2015
ER  -