Correspondence Response to Letter Regarding Article, “Arterial Pulse Wave Dynamics After Percutaneous Aortic Valve Replacement: Fall in Coronary Diastolic Suction With Increasing Heart Rate as a Basis for

We thank Lumley et al for their recent communication. The assessment of the effects of aortic stenosis is complex, involving interactions of the aorta, valvular stenosis, coronary artery, and myocardium. One of the key advantages of wave intensity is that it is able to separate the origin of each wave in the coronary artery to identify the upstream effects arising from the aorta from the downstream effects of the coronary microcirculation. Measured waves in coronary arteries are the amalgamation of millions of little wavelets traveling back from the vessels of the subtended territories.1 Thus, measuring at the ostium of the left main stem gives a snapshot of wave activity arising in vessels subtending the entire left ventricle. This has previously been investigated extensively, and similar wave patterns have been identified in each of the left coronary arteries.2 It is not uncommon for different modalities of aortic valve assessment to concord incompletely with one another3; this is due i