Detecting and capturing the images of Pressure Wave retrograde propagation due to Water Hammer Shock in coronary arteries

In coronary artery disease, the underlying mechanisms that initiate atherosclerosis and govern its progression or regression remain poorly understood. By conceptualizing the cardiovascular system as a network of pumps and pipes and applying the acoustic principles of sound wave propagation—where air molecules are displaced from equilibrium, generating alternating regions of compression and rarefaction secondary to water hammer event—we investigate whether this acoustic principle can detect high-contrast concentration zones (referred to as nodes) in coronary angiograms, and assess their significance. Methods: Utilizing a novel coronary angiographic technique, we first identified these nodes and analyzed the correlation between node locations and coronary lesions. Results: The preliminary data indicated that lesions commonly occurred at the node sites. At the location of transition from diastole to systole, lesions were more pronounced, as the low-pressure antegrade flow from diastole was collided by the high-pressure retrograde wave reflection of systole. Conversely, during the shift from systole to diastole, lesion severity decreased, with the pressure declining from systole to diastole. Outside of the node locations, no lesions were observed. Conclusions: The challenge remains: how can artificial intelligence (AI) and machine learning (ML) algorithms be applied to detect and identify these high-contrast nodes and correlate them with coronary lesions?