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dition to the standard measurements of pulmonary vascular resistance (PVR), mean pulmonary artery pressure (mPAP) and trans-pulmonary gradient (TPG), pulmonary artery pressure was sampled at 100Hz by a Radi PressureWire. The inflection point of wave reflection was determined as the point of first zero crossing from positive to negative of the fourth derivative of the pressure/time curve. PAI was calculated as the ratio of the difference in pulmonary artery systolic pressure to the pressure at the inflection point of wave reflection over the total pulmonary pulse pressure. Ti was defined as the time between the pulmonary artery diastolic pressure and the inflection point. Results: Mean TPG was 15±10.6mmHg, mean PVR was 2.8±2.3mmHg·min/l and mean mPAP was 29.5±14.4mmHg. There were significant positive correlations between the pulmonary augmentation index and TPG (r=0.61, p<0.005), mPAP (r=0.50, p<0.05) and PVR (r=0.45, p<0.05). There were significant inverse correlations between the time to inflection point and TPG (r=-0.60, p=0.005), PVR (r=-0.57, p<0.05) and with a trend to an inverse correlation with mPAP (r=-0.43, p=0.06). Conclusion: Pulmonary wave reflection appears to be correlated with traditional measures of right ventricular afterload, with increasing afterload associated with a higher pulmonary augmentation index and a shorter time to wave reflection.

european heart journal

Hypertrophy of right ventricular septomarginal trabeculation by cardiac magnetic resonance imaging predicts presence and severity of pulmonary hypertension and outcome