{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T08:43:37Z","timestamp":1790844217020,"version":"4.1.0"},"reference-count":22,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"18","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2025,9,16]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Pulmonary wave intensity analysis uses pressure and velocity data to assess the intensity, direction, type, and timing of waves. Its application in early and undifferentiated pulmonary hypertension (PH) to characterize right ventricular (RV)\u2013pulmonary arterial (PA) interactions has not been previously reported.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods<\/jats:title>\n            <jats:p xml:lang=\"en\">We hypothesized that wave intensity and speed would increase with mean PA pressure, while reflected wave timing would remain unchanged. Sixty patients with suspected PH underwent same\u2010day right heart catheterization and cardiac magnetic resonance. PA pressure and pulmonary vascular resistance were measured via right heart catheterization; PA flow, RV volumes, and function were assessed by cardiac magnetic resonance. Wave intensity analysis was derived from pressure and velocity changes. Linear and logistic regression were used for analysis.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Of the 60 patients (6 with mean PA pressure &lt;20\u2009mm\u2009Hg, 11 undifferentiated, 43 confirmed PH), all exhibited forward compression and decompression waves. A backward compression wave was present in 95%, while a backward decompression wave was found in 32%. Intensities of all 4 dominant waves increased with mean PA pressure (\n              <jats:italic toggle=\"no\">P<\/jats:italic>\n              &lt;0.01). Significant differences in reflection coefficient (\n              <jats:italic toggle=\"no\">P<\/jats:italic>\n              =0.04) and wave speed (\n              <jats:italic toggle=\"no\">P<\/jats:italic>\n              =0.01) were observed across PH subgroups. When present, the backward decompression wave showed the strongest associations with RV end\u2010diastolic (\u03b2=\u2212490.8) and end\u2010systolic volumes (\u03b2=\u2212495.9; both\n              <jats:italic toggle=\"no\">P<\/jats:italic>\n              &lt;0.01). Wave speed demonstrated the best performance for identifying abnormal RV end\u2010diastolic volume and RV end\u2010systolic volume (area under the curve, 0.73 and 0.80, respectively).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">In early and undifferentiated PH, peak wave intensity and speed increases with mean PA pressure, while reflected wave timing is unchanged. Wave intensity analysis metrics may aid in detecting PA stiffening before overt hemodynamic or structural RV changes.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.125.042831","type":"journal-article","created":{"date-parts":[[2025,8,30]],"date-time":"2025-08-30T06:43:38Z","timestamp":1756536218000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Assessment of Ventriculo\u2010Arterial Interactions in Early and Undifferentiated Pulmonary Hypertension Using Wave Intensity Analysis"],"prefix":"10.1161","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0040-7719","authenticated-orcid":false,"given":"Sara Louise","family":"Hungerford","sequence":"first","affiliation":[{"name":"The CardioVascular Center Tufts","place":["Boston, USA"]},{"name":"The University of Sydney","place":["Sydney, Australia"]},{"name":"Royal North Shore Hospital","place":["Sydney, Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7701-0878","authenticated-orcid":false,"given":"Gaurav","family":"Gulati","sequence":"additional","affiliation":[{"name":"The CardioVascular Center Tufts","place":["Boston, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5949-0812","authenticated-orcid":false,"given":"Kay","family":"Everett","sequence":"additional","affiliation":[{"name":"The CardioVascular Center Tufts","place":["Boston, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1052-2542","authenticated-orcid":false,"given":"Katherine","family":"Kearney","sequence":"additional","affiliation":[{"name":"UT Southwestern Medical Center","place":["Dallas, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edmund M.","family":"Lau","sequence":"additional","affiliation":[{"name":"The University of Sydney","place":["Sydney, Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3995-2466","authenticated-orcid":false,"given":"Daniel","family":"Burkhoff","sequence":"additional","affiliation":[{"name":"The Cardiovacsular Research Foundation","place":["New York, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5567-6206","authenticated-orcid":false,"given":"Audrey","family":"Adji","sequence":"additional","affiliation":[{"name":"The University of New South Wales","place":["Sydney, Australia"]},{"name":"Victor Chang Cardiac Research Institute","place":["Sydney, Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8302-6796","authenticated-orcid":false,"given":"Navin K.","family":"Kapur","sequence":"additional","affiliation":[{"name":"The CardioVascular Center Tufts","place":["Boston, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(67)90104-X"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1115\/1.2891191"},{"key":"e_1_3_2_4_2","unstructured":"Dwyer NB. Pulmonary arterial wave intensity analysis in health and disease: University Of Tasmania. 2010."},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41467-020-17318-x"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.4244\/EIJ-D-17-00567"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2022.01.327"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1002\/pul2.12345"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1002\/ehf2.14180"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1152\/ajpheart.00442.2020"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.14814\/phy2.15662"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.01913-2018"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1152\/ajpheart.00336.2006"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00156714"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2011.06.068"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1152\/ajpheart.1998.274.2.H500"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1093\/cvr\/22.9.627"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.RES.25.6.637"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF02058593"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00148313"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1152\/ajpheart.00480.2014"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.117.006679"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11517-009-0439-y"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.125.042831","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,18]],"date-time":"2025-09-18T03:58:17Z","timestamp":1758167897000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.125.042831"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,16]]},"references-count":22,"journal-issue":{"issue":"18","published-print":{"date-parts":[[2025,9,16]]}},"alternative-id":["10.1161\/JAHA.125.042831"],"URL":"https:\/\/doi.org\/10.1161\/jaha.125.042831","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,16]]},"assertion":[{"value":"2025-04-02","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-08-12","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-08-29","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e042831"}}