P1.4 HEMODYNAMICS OF PULMONARY HYPERTENSION: APPLICATION OF THE RESERVOIR-WAVE APPROACH
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...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
BMC
2015-11-01
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| Series: | Artery Research |
| Online Access: | https://www.atlantis-press.com/article/125930561/view |
| _version_ | 1818246998306848768 |
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| author | Anukul Ghimire* Mads Andersen Lindsay Burrowes J. Christopher Bouwmeester Andrew Grant Israel Belenkie Nowell Fine Barry Borlaug John Tyberg |
| author_facet | Anukul Ghimire* Mads Andersen Lindsay Burrowes J. Christopher Bouwmeester Andrew Grant Israel Belenkie Nowell Fine Barry Borlaug John Tyberg |
| author_sort | Anukul Ghimire* |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-12-12T14:57:43Z |
| format | Article |
| id | doaj.art-da9e471b30a1452fbf32cd3074528078 |
| institution | Directory Open Access Journal |
| issn | 1876-4401 |
| language | English |
| last_indexed | 2024-12-12T14:57:43Z |
| publishDate | 2015-11-01 |
| publisher | BMC |
| record_format | Article |
| series | Artery Research |
| spelling | doaj.art-da9e471b30a1452fbf32cd30745280782022-12-22T00:20:53ZengBMCArtery Research1876-44012015-11-011210.1016/j.artres.2015.10.198P1.4 HEMODYNAMICS OF PULMONARY HYPERTENSION: APPLICATION OF THE RESERVOIR-WAVE APPROACHAnukul Ghimire*Mads AndersenLindsay BurrowesJ. Christopher BouwmeesterAndrew GrantIsrael BelenkieNowell FineBarry BorlaugJohn TybergUsing 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.https://www.atlantis-press.com/article/125930561/view |
| spellingShingle | Anukul Ghimire* Mads Andersen Lindsay Burrowes J. Christopher Bouwmeester Andrew Grant Israel Belenkie Nowell Fine Barry Borlaug John Tyberg P1.4 HEMODYNAMICS OF PULMONARY HYPERTENSION: APPLICATION OF THE RESERVOIR-WAVE APPROACH Artery Research |
| title | P1.4 HEMODYNAMICS OF PULMONARY HYPERTENSION: APPLICATION OF THE RESERVOIR-WAVE APPROACH |
| title_full | P1.4 HEMODYNAMICS OF PULMONARY HYPERTENSION: APPLICATION OF THE RESERVOIR-WAVE APPROACH |
| title_fullStr | P1.4 HEMODYNAMICS OF PULMONARY HYPERTENSION: APPLICATION OF THE RESERVOIR-WAVE APPROACH |
| title_full_unstemmed | P1.4 HEMODYNAMICS OF PULMONARY HYPERTENSION: APPLICATION OF THE RESERVOIR-WAVE APPROACH |
| title_short | P1.4 HEMODYNAMICS OF PULMONARY HYPERTENSION: APPLICATION OF THE RESERVOIR-WAVE APPROACH |
| title_sort | p1 4 hemodynamics of pulmonary hypertension application of the reservoir wave approach |
| url | https://www.atlantis-press.com/article/125930561/view |
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