Abstract
Wave intensity analysis is calculated from simultaneously acquired measures of pressure and flow. Its mathematical computation produces a profile that provides quantitative information on the energy exchange driving blood flow acceleration and deceleration. Within the coronary circulation it has proven most useful in describing the wave that originates from the myocardium and that is responsible for driving the majority of coronary flow, labelled the backward decompression wave. Whilst this wave has demonstrated valuable insights into the pathogenic processes of a number of disease states, its measurement is hampered by its invasive necessity. However, recent work has used transthoracic echocardiography and an established measures of central aortic pressure to produce coronary flow velocity and pressure waveforms respectively. This has allowed a non-invasive measure of coronary wave intensity analysis, and in particular the backward decompression wave, to be calculated. It is anticipated that this will allow this tool to become more applicable and widespread, ultimately moving it from the research to the clinical domain.
Highlights
Wave intensity analysis was initially used in the field of gas dynamics but has found marked applicability in assessing cardiovascular physiology
It is useful in the coronary system as it can quantify the periodic forces acting within a single cardiac cycle but can separate them according to their point of origin
The most clinically relevant wave has proven to be the backward decompression wave (BDW) which originates from the myocardium and due to its decompressive nature is responsible for drawing blood into the coronary arteries
Summary
Wave intensity analysis was initially used in the field of gas dynamics but has found marked applicability in assessing cardiovascular physiology. To be comparable to ‘gold-standard’ invasive data [17, 18] (Fig. 3) Using this latter system, in conjunction with simultaneously measured coronary flow, non-invasive coronary wave-intensity analysis has recently been validated [5] and the same repeating patterns of waves can be appreciated within the cardiac cycle (Fig. 4). With the transition of coronary wave-intensity analysis into the non-invasive environment, a vast number of clinical investigative opportunities are opened As it can be measured in the majority of patients, carries no risk and requires. Because wave-intensity analysis is able to recognize subtle resting abnormalities in myocardial function [21] it may have potential in patients with risk factors for cardiovascular disease in order to stratify their pharmacological therapy In those at risk with an abnormal resting waveintensity profile, treatment could be instigated early and followed to ensure normalization. Its reproducibilty on a larger scale will be important to establish for work involving long-term patient follow-up
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
