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The pulmonary venous systolic flow pulse—its origin and relationship to left atrial pressure
- Source :
- Journal of the American College of Cardiology. 34(3):802-809
- Publication Year :
- 1999
- Publisher :
- Elsevier BV, 1999.
-
Abstract
- OBJECTIVESThe purpose of this study was to determine the origin of the pulmonary venous systolic flow pulse using wave-intensity analysis to separate forward- and backward-going waves.BACKGROUNDThe mechanism of the pulmonary venous systolic flow pulse is unclear and could be a “suction effect” due to a fall in atrial pressure (backward-going wave) or a “pushing effect” due to forward-propagation of right ventricular (RV) pressure (forward-going wave).METHODSIn eight patients during coronary surgery, pulmonary venous flow (flow probe), velocity (microsensor) and pressure (micromanometer) were recorded. We calculated wave intensity (dP × dU) as change in pulmonary venous pressure (dP) times change in velocity (dU) at 5 ms intervals. When dP × dU > 0 there is a net forward-going wave and when dP × dU < 0 there is a net backward-going wave.RESULTSSystolic pulmonary venous flow was biphasic. When flow accelerated in early systole (S1), pulmonary venous pressure was falling, and, therefore, dP × dU was negative, −0.6 ± 0.2 (x ± SE) W/m2, indicating a net backward-going wave. When flow accelerated in late systole (S2), pressure was rising, and, therefore, dP × dU was positive, 0.3 ± 0.1 W/m2, indicating a net forward-going wave.CONCLUSIONSPulmonary venous flow acceleration in S1 was attributed to a net backward-going wave secondary to a fall in atrial pressure. However, flow acceleration in S2 was attributed to a net forward-going wave, consistent with propagation of the RV systolic pressure pulse across the lungs. Pulmonary vein systolic flow pattern, therefore, appears to be determined by right- as well as left-sided cardiac events.
- Subjects :
- Male
medicine.medical_specialty
Suction
Systole
Atrial Pressure
Hemodynamics
Blood Pressure
Coronary Disease
Pulmonary vein
Monitoring, Intraoperative
Internal medicine
medicine
Humans
Coronary Artery Bypass
Aged
business.industry
Central venous pressure
Middle Aged
Blood pressure
Pulmonary Veins
Pulsatile Flow
Anesthesia
Circulatory system
Cardiology
Regression Analysis
Atrial Function, Left
Female
business
Cardiology and Cardiovascular Medicine
Blood Flow Velocity
Subjects
Details
- ISSN :
- 07351097
- Volume :
- 34
- Issue :
- 3
- Database :
- OpenAIRE
- Journal :
- Journal of the American College of Cardiology
- Accession number :
- edsair.doi.dedup.....4c323f2555ab2c10fc07bad3fae4e08e
- Full Text :
- https://doi.org/10.1016/s0735-1097(99)00300-9