Evidence of a dominant backward-propagating "suction" wave responsible for diastolic coronary filling in humans, attenuated in left ventricular hypertrophy
Evidence of a dominant backward-propagating "suction" wave responsible for diastolic coronary filling in humans, attenuated in left ventricular hypertrophy
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DOI：
10.1161/circulationaha.105.603050
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发表时间：
2006-04-11
期刊：
影响因子：
37.8
通讯作者：
Mayet, J
中科院分区：
文献类型：
--
作者：
Davies, JE;Whinnett, ZI;Mayet, J
背景-当主动脉血压下降时，冠状动脉血流量达到峰值。目前的模型无法完全解释这一现象。我们提出了一种新的方法，使用波强度分析，以解释这一现象在正常人和左心室肥厚（LVH）的影响进行评估。方法和结果，我们同时测量压力和多普勒速度与冠状动脉内导线在左主干，左前降支，回旋动脉的20名受试者后，正常冠状动脉造影。波强度分析用于识别和量化冠状动脉循环内的单个压力和速度波。确定了6个主导波的一致模式。加速血液沿沿着冠状动脉向前流动的波能量的94%来自两种波：第一种是由左心室射血引起的推波--主要的向前行进的推波;第二种是由心肌微循环压缩缓解引起的抽吸波--主要的向后行进的抽吸波。主要的向后行进的吸力波（18.2 +/- 13.7x10（3）W m（-2）s（-1），30%）大于主导的前向推进波（14.3 +/- 17.6x10（3）W m（-2）s（-1），22.3%，P=0.001），并与冠状动脉血流速度显著增加相关（0.51 vs 0.14 m/s，P
Background-Coronary blood flow peaks in diastole when aortic blood pressure has fallen. Current models fail to completely explain this phenomenon. We present a new approach-using wave intensity analysis-to explain this phenomenon in normal subjects and to evaluate the effects of left ventricular hypertrophy (LVH).Method and Results-We measured simultaneous pressure and Doppler velocity with intracoronary wires in the left main stem, left anterior descending, and circumflex arteries of 20 subjects after a normal coronary arteriogram. Wave intensity analysis was used to identify and quantify individual pressure and velocity waves within the coronary artery circulation. A consistent pattern of 6 predominating waves was identified. Ninety-four percent of wave energy, accelerating blood forward along the coronary artery, came from 2 waves: first a pushing wave caused by left ventricular ejection-the dominant forward-traveling pushing wave; and later a suction wave caused by relief of myocardial microcirculatory compression-the dominant backward-traveling suction wave. The dominant backward-traveling suction wave (18.2 +/- 13.7x10(3) W m(-2) s(-1), 30%) was larger than the dominant forward-traveling pushing wave (14.3 +/- 17.6x10(3) W m(-2) s(-1), 22.3%, P=0.001) and was associated with a substantially larger increment in coronary blood flow velocity (0.51 versus 0.14 m/s, P