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Direct and series transmission of left atrial pressure perturbations to the pulmonary artery: a study using wave-intensity analysis

¹Departments of Medicine, Anaesthesia, and Physiology and Biophysics, Cardiovascular Research Group, University of Calgary, Calgary, Alberta, Canada T2N 4N1; and ²Department of Bioengineering, Imperial College, London, United Kingdom SW7 2BX

Submitted 24 June 2002 ; accepted in final form 1 September 2003

Pressure waves are thought to travel from the left atrium (LA) to the pulmonary artery (PA) only retrogradely, via the vasculature. In seven anesthetized open-chest dogs, a balloon was placed in the LA, which was rapidly inflated and deflated during diastole, early systole, and late systole. High-fidelity pressures were measured within and around the heart. Measurements were made at low volume [LoV; left ventricular end-diastolic pressure (LVEDP) = 5–9 mmHg], high volume (HiV; LVEDP = 16–19 mmHg), and HiV with the pericardium removed. Wave-intensity analysis demonstrated that, except during late systole, balloon inflation created forward-going PA compression waves that were transmitted directly through the heart without measurable delay; backward PA compression waves were transmitted in-series through the pulmonary vasculature and arrived after delays of 90 ± 3 ms (HiV) and 103 ± 5 ms (LoV; P < 0.05). Direct transmission was greater during diastole, and both direct and series transmission increased with volume loading. Pressure waves from the LA arrive in the PA by two distinct routes: rapidly and directly through the heart and delayed and in-series through the pulmonary vasculature.

lung; arteries; hemodynamics; wave transmission

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