Wave reflection in an anatomical model of the pulmonary circulation in local and global hypertensive disease.

Pulmonary hypertension is a disease of the pulmonary vasculature which can occur for many different reasons, including pathological remodeling of the pulmonary vessels and occlusion of these vessels (amongst others). Pulmonary hypertension can lead to right heart failure and significantly reduces the quality of life of patients living with the condition. It is difficult to distinguish clinically between different classifications of pulmonary hypertension, and doing so accurately is critical for the management of an individual's condition. In addition, different presentations of the disease (e.g. occlusion versus remodeling) can put different strains on the right heart, despite patients having very similar elevations in pulmonary artery pressure. In this study we use an anatomically based model of the pulmonary circulation to predict pressure and flow wave transmission and reflection in two different kinds of pulmonary hypertension - primary pulmonary hypertension, and chronic thrombotic pulmonary embolism (CTEPH), to enable analysis of the impact of disease type on impedance spectra in the main pulmonary artery.