Pulmonary artery wave propagation and reservoir function in conscious man: impact of pulmonary vascular disease, respiration and dynamic stress tests
File(s)Proof of manuscript JP 2017.pdf (4.38 MB)
Accepted version
Author(s)
Type
Journal Article
Abstract
Detailed haemodynamic analysis may provide novel insights into the pulmonary circulation. Therefore, wave intensity and reservoir-excess pressure analyses were applied in the pulmonary artery to characterize changes in wave propagation and reservoir function during spontaneous respiration and dynamic stress tests. Right heart catheterization was performed using a pressure and Doppler flow sensor tipped guidewire to obtain simultaneous pressure and flow velocity measurements in the pulmonary artery in control subjects and patients with pulmonary arterial hypertension (PAH) at rest. In controls, recordings were also obtained during Valsalva manoeuvre and handgrip exercise. The asymptotic pressure at which the flow through the microcirculation ceases, the reservoir pressure related to arterial compliance and the excess pressure caused by arterial waves increased in PAH patients compared to controls. The systolic and diastolic rate constants also increased, while the diastolic time constant decreased. The forward compression wave energy decreased by ∼8% in controls and ∼6% in PAH patients during expiration compared to inspiration, while the wave speed remained unchanged throughout the respiratory cycle. Wave energy decreased during Valsalva manoeuvre (by ∼45%) and handgrip exercise (by ∼27%) with unaffected wave speed. Moreover, the reservoir and excess pressures decreased during Valsalva manoeuvre but remained unaltered during handgrip exercise. In conclusion, reservoir-excess pressure analysis applied to the pulmonary artery revealed distinctive differences between controls and PAH patients. Variations in the ventricular preload and afterload influence pulmonary arterial wave propagation as demonstrated by changes in wave energy during spontaneous respiration and dynamic stress tests.
Date Issued
2017-09-11
Date Acceptance
2017-08-14
Citation
JOURNAL OF PHYSIOLOGY-LONDON, 2017, 595 (20), pp.6463-6476
ISSN
0022-3751
Publisher
WILEY
Start Page
6463
End Page
6476
Journal / Book Title
JOURNAL OF PHYSIOLOGY-LONDON
Volume
595
Issue
20
Copyright Statement
© 2017 The Authors. The Journal of Physiology © 2017 The Physiological Society. This is the accepted version of the following article: Su, J., Manisty, C., Simonsen, U., Howard, L. S., Parker, K. H. and Hughes, A. D. (2017), Pulmonary artery wave propagation and reservoir function in conscious man: impact of pulmonary vascular disease, respiration and dynamic stress tests. J Physiol, 595: 6463–6476. doi:10.1113/JP274385, which has been published in final form at https://dx.doi.org/10.1113/JP274385
Identifier
http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000412888500015&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
Subjects
Science & Technology
Life Sciences & Biomedicine
Neurosciences
Physiology
Neurosciences & Neurology
pulmonary circulation
hemodynamics
pulse wave analysis
INTENSITY ANALYSIS
INPUT IMPEDANCE
CARDIOVASCULAR EVENTS
ISOMETRIC-EXERCISE
VALSALVA MANEUVER
HYPERTENSION
PRESSURE
SYSTEM
WINDKESSEL
RESISTANCE
06 Biological Sciences
11 Medical And Health Sciences
Publication Status
Published