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Alun Hughes edited textbf_The_fundamental_errors_The__.tex
almost 9 years ago
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\textbf{The fundamental errors}
The first major error is the assumption that RWC and iFR are directly related and that conclusions drawn from
our work on the two ideas can be
related to each other directly. treated as one. This assumption is not stated
directly overtly but it permeates almost all of their discussion.
In fact, iFR makes no use of the reservoir-wave concept and
none we are unaware of
our papers any publications before WSW that imply that it does. We did look into the idea of applying the reservoir pressure
using measured pressure and flow velocity to our coronary measurements and very quickly decided that it added nothing to the wave intensity
analysis based on the measured pressures. analysis. It is
my belief, and that of most of my colleagues, our belief that the reservoir pressure hypothesis is very likely to
fail be inappropriate in the coronary arteries because of their
limited compliance and their proximity to
the terminal reflection
sites. sites and other sources of backward travelling waves. We have used reservoir pressure analysis of pressure measured in various distal locations, e.g. the radial artery in the analysis of the CAFE
measurements study and while we have some reservations about
their interpretation in relation to current theories about the
validity of those calculations theoretically, reservoir, one cannot contest their epidemiological predictive power.
Conversely, iFR played no role in the
develpment development of the reservoir-wave hypothesis which antedated iFR by more than a decade. After the development of iFR there has never been any attempt to apply that principle to Pr.
Examples of this basic error will be discussed at various points in the following discussion which concentrates on first Pr and then iFR.