Wave intensity analysis of left ventricular filling: application of windkessel theory.

We extend our recently published windkessel-wave interpretation of vascular function to the wave intensity analysis (WIA) of left ventricular (LV) filling dynamics by separating the pressure changes due to the windkessel from those due to traveling waves. With the use of LV compliance, the change in pressure due solely to LV volume changes (windkessel pressure) can be isolated. Inasmuch as the pressure measured in the cardiovascular system is the sum of its windkessel and wave components (excess pressure), it can be substituted into WIA, yielding the isolated wave effects on LV filling. Our study of six open-chest dogs demonstrated that once the windkessel effects are removed from WIA, the energy of diastolic suction is 2.6 times greater than we previously calculated. Volume-related changes in pressure (i.e., the windkessel or reservoir effect) must be considered first when wave motion is analyzed.

[1]  ULFS‐49 Causes Bradycardia Without Decreasing Right Ventricular Systolic and Diastolic Performance , 1991, Journal of cardiovascular pharmacology.

[2]  J. Thomas,et al.  Determination of left ventricular chamber stiffness from the time for deceleration of early left ventricular filling. , 1995, Circulation.

[3]  O. Frank,et al.  Die grundform des arteriellen pulses , 1899 .

[4]  K. Parker,et al.  Wave-intensity analysis: a new approach to coronary hemodynamics. , 2000, Journal of applied physiology.

[5]  K. Parker,et al.  Forward and backward running waves in the arteries: analysis using the method of characteristics. , 1990, Journal of biomechanical engineering.

[6]  D. Greene,et al.  THE RESERVOIR FUNCTION OF THE LEFT ATRIUM DURING VENTRICULAR SYSTOLE. AN ANGIOCARDIOGRAPHIC STUDY OF ATRIAL STROKE VOLUME AND WORK. , 1964, The American journal of medicine.

[7]  Nigel G Shrive,et al.  Systemic venous circulation. Waves propagating on a windkessel: relation of arterial and venous windkessels to systemic vascular resistance. , 2006, American journal of physiology. Heart and circulatory physiology.

[8]  E. Yellin,et al.  Passive Properties of Canine Left Ventricle: Diastolic Stiffness and Restoring Forces , 1988, Circulation research.

[9]  J. Kisslo,et al.  Measurement of left ventricular volume in normal and volume-overloaded canine hearts. , 1994, The American journal of physiology.

[10]  E. R. Smith,et al.  Experimental instrumentation and left ventricular pressure-strain relationship. , 1991, The American journal of physiology.

[11]  P. Altieri,et al.  Left Ventricular Wall Motion During the Isovolumic Relaxation Period , 1973, Circulation.

[12]  J. Tyberg,et al.  Mechanics of ventricular diastole. , 1970, Cardiovascular research.

[13]  P. Ludbrook,et al.  Transmitral pressure-flow velocity relation. Importance of regional pressure gradients in the left ventricle during diastole. , 1988, Circulation.

[14]  J C Greenfield,et al.  The Three‐Dimensional Dynamic Geometry of the Left Ventricle in the Conscious Dog , 1976, Circulation research.

[15]  P. Frihauf,et al.  Time-varying effective mitral valve area: prediction and validation using cardiac MRI and Doppler echocardiography in normal subjects. , 2004, American journal of physiology. Heart and circulatory physiology.

[16]  D. Adams,et al.  Shape and Volume Changes During “Isovolumetric Relaxation’ in Normal and Asynergic Ventricles , 1974, Circulation.

[17]  A. Bolger,et al.  Mitral valve opening in the ovine heart. , 1998, The American journal of physiology.

[18]  James Lighthill,et al.  Waves In Fluids , 1966 .

[19]  Nigel G Shrive,et al.  Time-domain representation of ventricular-arterial coupling as a windkessel and wave system. , 2003, American journal of physiology. Heart and circulatory physiology.

[20]  K. Parker,et al.  Left ventricular wave speed. , 2001, Journal of applied physiology.

[21]  Catherine M. Otto,et al.  Textbook of Clinical Echocardiography , 2004 .

[22]  K. Parker,et al.  Assessment of left ventricular diastolic suction in dogs using wave-intensity analysis. , 2005, American journal of physiology. Heart and circulatory physiology.