title: Chasing the reflected wave back into the heart: a new hypothesis while the jury is still out.
abstract: BACKGROUND
  Arterial stiffness directly influences cardiac function and is independently associated with cardiovascular risk. However, the influence of the aortic reflected pulse pressure wave on left ventricular function has not been well characterized. The aim of this study was to obtain detailed information on regional ventricular wall motion patterns corresponding to the propagation of the reflected aortic wave on ventricular segments.
  
  
  METHODS
  Left ventricular wall motion was investigated in a group of healthy volunteers (n = 14, age 23 ± 3 years), using cardiac magnetic resonance navigator-gated tissue phase mapping. The left ventricle was divided into 16 segments and regional wall motion was studied in high temporal detail.
  
  
  RESULTS
  Corresponding to the expected timing of the reflected aortic wave reaching the left ventricle, a characteristic "notch" of regional myocardial motion was seen in all radial, circumferential, and longitudinal velocity graphs. This notch was particularly prominent in septal segments adjacent to the left ventricular outflow tract on radial velocity graphs and in anterior and posterior left ventricular segments on circumferential velocity graphs. Similarly, longitudinal velocity graphs demonstrated a brief deceleration in the upward recoil motion of the entire ventricle at the beginning of diastole.
  
  
  CONCLUSIONS
  These results provide new insights into the possible influence of the reflected aortic waves on ventricular segments. Although the association with the reflected wave appears to us to be unambiguous, it represents a novel research concept, and further studies enabling the actual recording of the pulse wave are required.
authors: Department of Physiology, Anatomy, and Genetics, University of Oxford, UK. codrion@yahoo.com
authors: Ion
authors: I
authors: Codreanu
authors: Matthew D
authors: MD
authors: Robson
authors: Oliver J
authors: OJ
authors: Rider
authors: Tammy J
authors: TJ
authors: Pegg
authors: Bernd A
authors: BA
authors: Jung
authors: Constantin A
authors: CA
authors: Dasanu
authors: Kieran
authors: K
authors: Clarke
authors: Cameron J
authors: CJ
authors: Holloway
mesh_terms: D000328:Adult; D001011:Aorta / Q000502:physiology*; D001794:Blood Pressure; D004548:Elasticity; D004739:England; D006801:Humans; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D009200:Myocardial Contraction; D011673:Pulsatile Flow; D012039:Regional Blood Flow; D013997:Time Factors; D016277:Ventricular Function, Left; D055815:Young Adult