3.4 WAVE INTENSITY ANALYSIS PROVIDES NOVEL INSIGHTS INTO PULMONARY HYPERTENSION

• Main Authors: Junjing Su, Charlotte Manisty, Kim H. Parker, Soren Mellemkjaer, Luke Howard, Ulf Simonsen, Alun Hughes
• Format: Article
• Language: English
• Published: Atlantis Press 2016-11-01
• Series: Artery Research
• Online Access: https://www.atlantis-press.com/article/125930399/view

Background: The objective of the study was to apply wave intensity analysis (WIA) in the pulmonary artery to characterise the magnitude, origin, type and timing of arterial waves in individuals with and without pulmonary hypertension (PH). Methods: Right heart catheterisation was performed using a pressure and Doppler flow sensor tipped catheter to obtain simultaneous pressure and flow velocity measurements in the pulmonary artery. WIA was applied to the acquired data (1). Results: In controls (n = 10), the wave speed in the pulmonary artery was 3.03 m/s (2.69 – 3.91 m/s) and this increased in pulmonary arterial hypertension (PAH, n = 11, 11.9 m/s [10.5 – 16.4 m/s]) and chronic thromboembolic pulmonary hypertension patients (CTEPH, n = 10, 15.1 m/s [11.5 – 16.8 m/s]). Wave intensity was significantly greater in PH patients compared to controls. Wave reflection index (WRI) was 3.81 % (3.58 – 6.24 %) in controls, 23.4 % (17.5 – 29.7 %) in PAH and 30.4 % (11.9 – 35.6 %) in CTEPH patients. WRI was not related to pulmonary vascular resistance or right ventricular fractional area change and patients with mildly and severely elevated pulmonary pressure had similar WRI. Conclusions: Wave speed, wave intensity and wave reflection in the pulmonary artery was higher in PH patients indicating increased arterial stiffness, right ventricular work and vascular impedance mismatch, respectively. While WRI does not reflect the severity of PH in established disease, the presence of increased wave reflection could be a novel early marker of pulmonary vascular disease.