Pulmonary wave intensity analysis to assess ventriculo-arterial interactions in cardiogenic shock

Background Pulmonary wave intensity analysis (WIA) uses pressure and velocity measurements to characterize the type, direction, and timing of energy waves within the pulmonary circulation. Its application to assess ventriculo-arterial (VA) interactions in patients with cardiogenic shock (CS) receiving mechanical circulatory support (MCS) has not been previously described. We hypothesized that forward wave intensity would be reduced in CS, with preserved or augmented reflected wave intensity and/or speed. Study Design and Methods In this prospective cohort study, 19 patients with CS requiring MCS were compared with 10 patients with normal pulmonary artery (PA) hemodynamics. PA pressure was measured via right heart catheterization (RHC), and PA flow via Doppler transthoracic echocardiography (TTE). WIA was derived from the product of pressure and velocity change. Statistical significance was defined as P