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Am J Physiol Heart Circ Physiol (September 25, 2003). doi:10.1152/ajpheart.00505.2002
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Submitted on June 24, 2002
Accepted on September 1, 2003

Direct and Series Transmission of Left Atrial Pressure Perturbations to the Pulmonary Artery: A Study Using Wave-Intensity Analysis

Ellen H. Hollander1, Gary M. Dobson1, Jiun-Jr Wang1, Kim H. Parker1, and John V. Tyberg1*

1 Departments of Medicine , Anaesthesia, and Physiology and Biophysics, University of Calgary, Calgary, Alberta, Canada

* To whom correspondence should be addressed. E-mail: jtyberg{at}ucalgary.ca.

Pressure waves are thought to travel from the left atrium (LA) to the pulmonary artery (PA) only retrogradely, via the vasculature. In 7 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; LVEDP=5-9 mm Hg), high volume (HiV; LVEDP=16-19 mm Hg), and HiV with the pericardium removed (HiVPer-). Wave-intensity analysis demonstrated that, except during late systole, balloon inflation created forward-going PA compression waves which 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.




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