![]() ![]() In conclusion, presumptions based on WIA have led to misconceptions that violate physical principles, and reservoir-wave concept and iFR should be abandoned. The ratio of diastolic aortic pressure and flow implies division by zero giving nonsensical results. The iFR is also not without flaws, as easily demonstrated when applied to the aorta. Taken together, P res seems to behave as a wave, rather than P exc. Hence, in contrast, P exc is minimally affected by wave reflections. The presumed wave-less P res equals twice the backward pressure wave and travels, arriving later in the distal aorta. The reservoir-wave concept, however, is internally inconsistent. Because this Windkessel model falls short in systole an excess pressure, P exc, is introduced, which is assumed to have wave properties. The reservoir-wave concept introduces a reservoir pressure, P res, (Frank Windkessel) as a wave-less phenomenon. ![]() Nevertheless, this seemingly wave-free period in diastole formed the basis of both the reservoir-wave concept and the Instantaneous wave-Free Ratio of (iFR) pressure and flow. Both the methods thus give similar results including backward waves spanning systole and diastole. However, integration of the WIA-obtained forward and backward waves is equal to the wave separation analysis–obtained waves. Because differentiation emphasizes rapid changes, WIA suppresses slow (diastolic) fluctuations of the waves and renders diastole a seemingly wave-free period. While wave separation analysis uses measured pressure and flow, WIA uses their derivatives. Wave separation analysis and wave intensity analysis (WIA) use (aortic) pressure and flow to separate them in their forward and backward (reflected) waves.
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