P502Application of carotid artery wave intensity analysis in the clinical setting


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Abstract

Introduction: Wave intensity (WI) is a recently evolved haemodynamic index reflecting ventriculoarterial interaction.Objective: To evaluate the correlation of WI parameters with demographic and clinical factors and echocardiographic measurements. To study the influence of diastolic dysfunction (DDf) on WI parameters.Methods: We studied 120 patients (mean age 57±16 y, 32% female). WI analysis was performed on the common carotid artery, bilaterally, and icluded (mmHg m/s3): W1 – 1st forward traveling compression wave, W2 – 2nd forward traveling expansion wave, NA (negative area) – backward traveling compression wave.Results: Patients with arterial hypertension (AH) had higher W1 values (11.06 and 6.07, respectively, p=0.001) and NA (86.85 and 27.72, respectively, p=0.006). Smokers had lower W2 values (1.11 and 2.32, respectively, p=0.028). The other demographical and clinical parameters did not influence WI values. W1 correlated positively with ejection fraction (EF) (correlation coefficient 0.46, p=0.005), septum and posterior wall thickness (0.28, p=0.04, and 0.37, p=0.005, respectively) and negatively with left ventricular end-systolic diameter and volume (LVESD, LVESV) (-0.33, p=0.012, and -0.31, p=0.018, respectively). W2 correlated positively with EF (0.28, p=0.039) and negatively with LVESD (-0.27, p=0.035), LVESV (-0.32, p=0.013), and deceleration time (-0.28, p=0.036). NA showed significant positive correlation with left atrial dimensions (0.45, p=0.009) and septum and posterior wall thickness (0.4 and 0.46, respectively, p<0.001). When we divided the patients into 3 groups with respect to their LV diastolic function (normal – 38 patients, impaired LV relaxation – 49 patients and impaired relaxation with reduced compliance and elevation of LV end-diastolic pressure – 33 patients) we found the following relationship: values of W1 and NA did not differ between groups while W2 values showed significant between-group variation. They decreased progressively with advancing degrees of DDf: 2.9±1.5, 1.7±1.3 and 0.5±0.3, respectively, p<0.001.Conclusion: Clinical parameters have differential influence on WI parameters, with AH affecting the early systolic components (W1 and NA) and smoking – the late systolic events as W2. WI parameters correlated with several echocardiographic parameters, the most significant correlations being: W1 and EF (positive) and NA with septum and posterior wall thickness and left atrial dimension. Only W2 of WI parameters is influenced by LV diastolic function: advancing stages of DDf are associated with progressive decrease in W2 values.

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