Heart Research Group, Murdoch Childrens Research Institute, Melbourne, Victoria, Australia.
J Hypertens. 2012 Apr;30(4):734-43. doi: 10.1097/HJH.0b013e32834f9793.
Arterial wave reflection has traditionally been quantified from pressure and flow measurements using wave separation and wave intensity (WI) analysis. In the recently proposed reservoir-wave paradigm, these analyses are performed after dividing pressure into 'reservoir' and 'excess' components, yielding a modified wave intensity (WI(RW)). This new approach has led to controversial conclusions about the nature and significance of arterial wave reflection. Our aim was to assess whether WI or WI(RW) more accurately represent wave phenomena.
We studied two computer models (a simple network and a full model of the systemic arterial tree) in which all systolic forward waves and reflection properties were known a priori. Results of these models were compared with haemodynamic measurements in the ascending aorta of five adult sheep at baseline and after incremental arterial constriction.
The key findings of model studies were that the reservoir-wave approach markedly underestimated or eliminated reflected compression waves, overestimated or artefactually introduced forward and backward expansion waves, and displayed nonphysical interactions between distal reflection sites and early systolic waves. These errors arose because, contrary to a key assumption of the reservoir-wave approach, reservoir pressure was not spatially uniform during systole. In-vivo results were qualitatively similar to model results, with baseline WI and WI(RW) suggesting that the arterial network was dominated by positive and negative wave reflection, respectively, while under all conditions, reflected WI(RW) compression waves were substantially smaller than corresponding WI waves.
We conclude that the reservoir-wave paradigm introduces error into arterial wave analyses.
传统上，通过压力和流量测量使用波分离和波强（WI）分析来量化动脉波反射。在最近提出的储层波范例中，在将压力分为“储层”和“过剩”分量之后，对这些分析进行了分析，从而产生了改进的波强（WI（RW））。这种新方法导致了关于动脉波反射的性质和意义的争议性结论。我们的目的是评估 WI 或 WI（RW）是否更准确地代表波现象。
我们研究了两个计算机模型（一个简单的网络和一个全身动脉树的完整模型），其中所有的收缩正向波和反射特性都是事先已知的。将这些模型的结果与五只成年绵羊升主动脉的血流动力学测量值进行了比较，分别在基线和递增性动脉收缩时进行了比较。
模型研究的主要发现是，储层波方法明显低估或消除了反射压缩波，高估或人为引入了正向和反向扩张波，并显示了远端反射部位与早期收缩波之间的非物理相互作用。这些错误的产生是因为，与储层波方法的一个关键假设相反，储层压力在收缩期间不是空间均匀的。体内结果与模型结果定性相似，基线 WI 和 WI（RW）表明，动脉网络分别由正波和负波反射主导，而在所有条件下，反射性 WI（RW）压缩波都明显小于相应的 WI 波。
我们得出结论，储层波范例会给动脉波分析带来误差。
