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1 Imperial College & St Mary's Hospital, International Centre of Circulatory Health, London, United Kingdom
* To whom correspondence should be addressed. E-mail: justindavies{at}heart123.com.
Background It has not been possible to measure wave speed in the human coronary artery, because the vessel is too short for the conventional two-point measurement technique used in the aorta. We present a new method derived from wave intensity analysis, which allows wave speed to be measured at a single point. We apply this in the aorta and then use it to derive wave speed in the human coronary artery for the first time. Method and Results We measured simultaneous pressure and Doppler velocity with intracoronary wires, at the left main stem, left anterior descending, circumflex and aorta in 14 subjects, following a normal coronary arteriogram. Ten subsequently underwent serial measurements along the aorta and repeat coronary measurements after intracoronary isosorbide dinitrate. Wave speed was derived by two methods in the aorta: first, by the two-site distance/time method (foot-to-foot delay of pressure waveforms); second, by a new single-point method using simultaneous pressure and velocity measurements. Coronary wave speed was derived by the single-point method. Wave speed derived by the two methods correlated well (r=0.72, p<0.05). Coronary wave speed correlated with aortic wave speed (r=0.72, p=0.002). Following nitrate, coronary wave speed fell by 43% from 16.4±6m/s to 9.3±4.5m/s (p<0.001). Conclusion This single-point method allows wave speed to be determined in the human coronary artery. Aortic wave speed is correlated to coronary wave speed. Finally, this technique detects the prompt fall in coronary artery wave speed with isosorbide dinitrate.
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