| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
1 Cardiovascular Imaging Center, Department of Cardiology, The Cleveland Clinic Foundation, Cleveland, Ohio 44195; and 2 Heart Center Limburg, Genk 3600, Belgium
Previous studies have shown that small
intraventricular pressure gradients (IVPG) are important for efficient
filling of the left ventricle (LV) and as a sensitive marker for
ischemia. Unfortunately, there has previously been no way of
measuring these noninvasively, severely limiting their research and
clinical utility. Color Doppler M-mode (CMM) echocardiography provides
a spatiotemporal velocity distribution along the inflow tract
throughout diastole, which we hypothesized would allow direct
estimation of IVPG by using the Euler equation. Digital CMM images,
obtained simultaneously with intracardiac pressure waveforms in six
dogs, were processed by numerical differentiation for the Euler
equation, then integrated to estimate IVPG and the total (left atrial
to left ventricular apex) pressure drop. CMM-derived estimates agreed
well with invasive measurements (IVPG: y = 0.87x + 0.22, r = 0.96, P < 0.001, standard error of the estimate = 0.35 mmHg). Quantitative processing of CMM data allows accurate estimation
of IVPG and tracking of changes induced by 
-adrenergic stimulation.
This novel approach provides unique information on LV filling dynamics
in an entirely noninvasive way that has previously not been available
for assessment of diastolic filling and function.
diastole; hemodynamics; ventricles
This article has been cited by other articles:
|
|
 |
|
  B. T. Esch, J. M. Scott, D. E.R. Warburton, R. Thompson, D. Taylor, J. C. Baron, I. Paterson, and M. J. Haykowsky Left ventricular torsion and untwisting during exercise in heart transplant recipients J. Physiol., May 15, 2009; 587(10): 2375 - 2386. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Buakhamsri, Z. B. Popovic, J. Lin, P. Lim, N. L. Greenberg, A. G. Borowski, W.H. W. Tang, A. L. Klein, H. M. Lever, M. Y. Desai, et al. Impact of left ventricular volume/mass ratio on diastolic function Eur. Heart J., May 2, 2009; 30(10): 1213 - 1221. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. F. Nagueh, C. P. Appleton, T. C. Gillebert, P. N. Marino, J. K. Oh, O. A. Smiseth, A. D. Waggoner, F. A. Flachskampf, P. A. Pellikka, and A. Evangelisa Recommendations for the Evaluation of Left Ventricular Diastolic Function by Echocardiography Eur J Echocardiogr, March 1, 2009; 10(2): 165 - 193. [Full Text] [PDF]
|
|
|
|
 |
|
 W. Zhang, C. S. Chung, L. Shmuylovich, and S. J. Kovacs Is left ventricular volume during diastasis the real equilibrium volume, and what is its relationship to diastolic suction? J Appl Physiol, September 1, 2008; 105(3): 1012 - 1014. [Full Text] [PDF]
|
|
|
|
 |
|
 Y. Notomi, Z. B. Popovic, H. Yamada, D. W. Wallick, M. G. Martin, S. J. Oryszak, T. Shiota, N. L. Greenberg, and J. D. Thomas Ventricular untwisting: a temporal link between left ventricular relaxation and suction Am J Physiol Heart Circ Physiol, January 1, 2008; 294(1): H505 - H513. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. D. Thomas and Z. B. Popovic Assessment of Left Ventricular Function by Cardiac Ultrasound J. Am. Coll. Cardiol., November 21, 2006; 48(10): 2012 - 2025. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Z. B. Popovic, K. E. Richards, N. L. Greenberg, A. Rovner, J. Drinko, Y. Cheng, M. S. Penn, K. Fukamachi, N. Mal, B. D. Levine, et al. Scaling of diastolic intraventricular pressure gradients is related to filling time duration Am J Physiol Heart Circ Physiol, August 1, 2006; 291(2): H762 - H769. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Y. Notomi, M. G. Martin-Miklovic, S. J. Oryszak, T. Shiota, D. Deserranno, Z. B. Popovic, M. J. Garcia, N. L. Greenberg, and J. D. Thomas Enhanced Ventricular Untwisting During Exercise: A Mechanistic Manifestation of Elastic Recoil Described by Doppler Tissue Imaging Circulation, May 30, 2006; 113(21): 2524 - 2533. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Z. B. Popovic, A. Prasad, M. J. Garcia, A. Arbab-Zadeh, A. Borowski, E. Dijk, N. L. Greenberg, B. D. Levine, and J. D. Thomas Relationship among diastolic intraventricular pressure gradients, relaxation, and preload: impact of age and fitness Am J Physiol Heart Circ Physiol, April 1, 2006; 290(4): H1454 - H1459. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W. C. Little Diastolic Dysfunction Beyond Distensibility: Adverse Effects of Ventricular Dilatation Circulation, November 8, 2005; 112(19): 2888 - 2890. [Full Text] [PDF]
|
|
|
|
|
|
A. Rovner, N. L. Greenberg, J. D. Thomas, and M. J. Garcia Relationship of diastolic intraventricular pressure gradients and aerobic capacity in patients with diastolic heart failure Am J Physiol Heart Circ Physiol, November 1, 2005; 289(5): H2081 - H2088. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Rovner, R. Smith, N. L. Greenberg, E. M. Tuzcu, N. Smedira, H. M. Lever, J. D. Thomas, and M. J. Garcia Improvement in diastolic intraventricular pressure gradients in patients with HOCM after ethanol septal reduction Am J Physiol Heart Circ Physiol, December 1, 2003; 285(6): H2492 - H2499. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Urheim, T. Edvardsen, K. Steine, H. Skulstad, E. Lyseggen, O. Rodevand, and O. A. Smiseth Postsystolic shortening of ischemic myocardium: a mechanism of abnormal intraventricular filling Am J Physiol Heart Circ Physiol, June 1, 2003; 284(6): H2343 - H2350. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. D. Thomas, M. S. Firstenberg, P. M. Vandervoort, N. L. Greenberg, N. G. Smedira, P. M. McCarthy, and M. J. Garcia Reply J. Am. Coll. Cardiol., July 1, 2001; 38(1): 291 - 292. [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| Visit Other APS Journals Online |
