{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T23:45:07Z","timestamp":1791243907436,"version":"4.1.0"},"reference-count":24,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"14","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2006,4,11]]},"abstract":"<jats:p>\n            <jats:bold>\n              <jats:italic>Background\u2014<\/jats:italic>\n            <\/jats:bold>\n            Coronary blood flow peaks in diastole when aortic blood pressure has fallen. Current models fail to completely explain this phenomenon. We present a new approach\u2014using wave intensity analysis\u2014to explain this phenomenon in normal subjects and to evaluate the effects of left ventricular hypertrophy (LVH).\n          <\/jats:p>\n          <jats:p>\n            <jats:bold>\n              <jats:italic>Method and Results\u2014<\/jats:italic>\n            <\/jats:bold>\n            We measured simultaneous pressure and Doppler velocity with intracoronary wires in the left main stem, left anterior descending, and circumflex arteries of 20 subjects after a normal coronary arteriogram. Wave intensity analysis was used to identify and quantify individual pressure and velocity waves within the coronary artery circulation. A consistent pattern of 6 predominating waves was identified. Ninety-four percent of wave energy, accelerating blood forward along the coronary artery, came from 2 waves: first a pushing wave caused by left ventricular ejection\u2014the dominant forward-traveling pushing wave; and later a suction wave caused by relief of myocardial microcirculatory compression\u2014the dominant backward-traveling suction wave. The dominant backward-traveling suction wave (18.2\u00b113.7\u00d710\n            <jats:sup>3<\/jats:sup>\n            W m\n            <jats:sup>\u22122<\/jats:sup>\n            s\n            <jats:sup>\u22121<\/jats:sup>\n            , 30%) was larger than the dominant forward-traveling pushing wave (14.3\u00b117.6\u00d710\n            <jats:sup>3<\/jats:sup>\n            W m\n            <jats:sup>\u22122<\/jats:sup>\n            s\n            <jats:sup>\u22121<\/jats:sup>\n            , 22.3%,\n            <jats:italic>P<\/jats:italic>\n            =0.001) and was associated with a substantially larger increment in coronary blood flow velocity (0.51 versus 0.14 m\/s,\n            <jats:italic>P<\/jats:italic>\n            &lt;0.001). In LVH, the dominant backward-traveling suction wave percentage was significantly decreased (33.1% versus 26.9%,\n            <jats:italic>P<\/jats:italic>\n            =0.01) and inversely correlated with left ventricular septal wall thickness (\n            <jats:italic>r<\/jats:italic>\n            =\u22120.52,\n            <jats:italic>P<\/jats:italic>\n            &lt;0.02).\n          <\/jats:p>\n          <jats:p>\n            <jats:bold>\n              <jats:italic>Conclusions\u2014<\/jats:italic>\n            <\/jats:bold>\n            Six waves predominantly drive human coronary blood flow. Coronary flow peaks in diastole because of the dominance of a \u201csuction\u201d wave generated by myocardial microcirculatory decompression. This is significantly reduced in LVH.\n          <\/jats:p>","DOI":"10.1161\/circulationaha.105.603050","type":"journal-article","created":{"date-parts":[[2006,4,4]],"date-time":"2006-04-04T00:34:19Z","timestamp":1144110859000},"page":"1768-1778","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":371,"title":["Evidence of a Dominant Backward-Propagating \u201cSuction\u201d Wave Responsible for Diastolic Coronary Filling in Humans, Attenuated in Left Ventricular Hypertrophy"],"prefix":"10.1161","volume":"113","author":[{"given":"Justin E.","family":"Davies","sequence":"first","affiliation":[{"name":"From the International Centre for Circulatory Health, St Mary\u2019s Hospital and Imperial College (J.E.D., Z.I.W., D.P.F., C.H.M., R.A.F., I.S.M., A.D.H., J.M.); the Department of Bioengineering, Physiological Flow Unit, Imperial College (J.A.-S., K.H.P.); and the Department of Clinical Engineering, Royal Brompton Hospital (K.W.), London, United Kingdom."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zachary I.","family":"Whinnett","sequence":"additional","affiliation":[{"name":"From the International Centre for Circulatory Health, St Mary\u2019s Hospital and Imperial College (J.E.D., Z.I.W., D.P.F., C.H.M., R.A.F., I.S.M., A.D.H., J.M.); the Department of Bioengineering, Physiological Flow Unit, Imperial College (J.A.-S., K.H.P.); and the Department of Clinical Engineering, Royal Brompton Hospital (K.W.), London, United Kingdom."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Darrel P.","family":"Francis","sequence":"additional","affiliation":[{"name":"From the International Centre for Circulatory Health, St Mary\u2019s Hospital and Imperial College (J.E.D., Z.I.W., D.P.F., C.H.M., R.A.F., I.S.M., A.D.H., J.M.); the Department of Bioengineering, Physiological Flow Unit, Imperial College (J.A.-S., K.H.P.); and the Department of Clinical Engineering, Royal Brompton Hospital (K.W.), London, United Kingdom."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlotte H.","family":"Manisty","sequence":"additional","affiliation":[{"name":"From the International Centre for Circulatory Health, St Mary\u2019s Hospital and Imperial College (J.E.D., Z.I.W., D.P.F., C.H.M., R.A.F., I.S.M., A.D.H., J.M.); the Department of Bioengineering, Physiological Flow Unit, Imperial College (J.A.-S., K.H.P.); and the Department of Clinical Engineering, Royal Brompton Hospital (K.W.), London, United Kingdom."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jazmin","family":"Aguado-Sierra","sequence":"additional","affiliation":[{"name":"From the International Centre for Circulatory Health, St Mary\u2019s Hospital and Imperial College (J.E.D., Z.I.W., D.P.F., C.H.M., R.A.F., I.S.M., A.D.H., J.M.); the Department of Bioengineering, Physiological Flow Unit, Imperial College (J.A.-S., K.H.P.); and the Department of Clinical Engineering, Royal Brompton Hospital (K.W.), London, United Kingdom."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keith","family":"Willson","sequence":"additional","affiliation":[{"name":"From the International Centre for Circulatory Health, St Mary\u2019s Hospital and Imperial College (J.E.D., Z.I.W., D.P.F., C.H.M., R.A.F., I.S.M., A.D.H., J.M.); the Department of Bioengineering, Physiological Flow Unit, Imperial College (J.A.-S., K.H.P.); and the Department of Clinical Engineering, Royal Brompton Hospital (K.W.), London, United Kingdom."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rodney A.","family":"Foale","sequence":"additional","affiliation":[{"name":"From the International Centre for Circulatory Health, St Mary\u2019s Hospital and Imperial College (J.E.D., Z.I.W., D.P.F., C.H.M., R.A.F., I.S.M., A.D.H., J.M.); the Department of Bioengineering, Physiological Flow Unit, Imperial College (J.A.-S., K.H.P.); and the Department of Clinical Engineering, Royal Brompton Hospital (K.W.), London, United Kingdom."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iqbal S.","family":"Malik","sequence":"additional","affiliation":[{"name":"From the International Centre for Circulatory Health, St Mary\u2019s Hospital and Imperial College (J.E.D., Z.I.W., D.P.F., C.H.M., R.A.F., I.S.M., A.D.H., J.M.); the Department of Bioengineering, Physiological Flow Unit, Imperial College (J.A.-S., K.H.P.); and the Department of Clinical Engineering, Royal Brompton Hospital (K.W.), London, United Kingdom."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alun D.","family":"Hughes","sequence":"additional","affiliation":[{"name":"From the International Centre for Circulatory Health, St Mary\u2019s Hospital and Imperial College (J.E.D., Z.I.W., D.P.F., C.H.M., R.A.F., I.S.M., A.D.H., J.M.); the Department of Bioengineering, Physiological Flow Unit, Imperial College (J.A.-S., K.H.P.); and the Department of Clinical Engineering, Royal Brompton Hospital (K.W.), London, United Kingdom."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kim H.","family":"Parker","sequence":"additional","affiliation":[{"name":"From the International Centre for Circulatory Health, St Mary\u2019s Hospital and Imperial College (J.E.D., Z.I.W., D.P.F., C.H.M., R.A.F., I.S.M., A.D.H., J.M.); the Department of Bioengineering, Physiological Flow Unit, Imperial College (J.A.-S., K.H.P.); and the Department of Clinical Engineering, Royal Brompton Hospital (K.W.), London, United Kingdom."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jamil","family":"Mayet","sequence":"additional","affiliation":[{"name":"From the International Centre for Circulatory Health, St Mary\u2019s Hospital and Imperial College (J.E.D., Z.I.W., D.P.F., C.H.M., R.A.F., I.S.M., A.D.H., J.M.); the Department of Bioengineering, Physiological Flow Unit, Imperial College (J.A.-S., K.H.P.); and the Department of Clinical Engineering, Royal Brompton Hospital (K.W.), London, United Kingdom."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_1_2","first-page":"70","year":"1696","unstructured":"Scaramucci J. Theoremata familiaria viros eruditos consulentia de variis physico-medicis lucubrationibus juxta leges mecanicas. Apud Joannem Baptistam Bustum. 1696; 70\u201381.","journal-title":"Apud Joannem Baptistam Bustum"},{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.15.1.14"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/res.36.6.1132069"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/res.49.3.7261259"},{"key":"e_1_3_2_5_2","first-page":"H1471","volume":"257","year":"1989","unstructured":"Krams R, Sipkema P, Westerhof N. Varying elastance concept may explain coronary systolic flow impediment. 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