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Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, Maryland 21224
Most noninvasive measures of diastolic
function are made during left ventricular (LV) filling and are
therefore subject to "pseudonormalization," because variation in
left atrial (LA) pressure may confound the estimation of relaxation
rate. Counterclockwise twist of the LV develops during ejection, but
untwisting occurs rapidly during isovolumic relaxation, before mitral
opening. We hypothesized that the rate of untwisting might reflect the
process of relaxation independent of LA pressure. Recoil rate (RR), the velocity of LV untwisting, was measured by tagged magnetic resonance imaging and regressed against the relaxation time constant (
), recorded by catheterization, in 10 dogs at baseline and after dobutamine, saline, esmolol, and methoxamine treatment. RR correlated closely (average r = 
0.86) with and was
unaffected by elevated LA pressure. Multiple regression showed that
, but not LA or aortic pressure, was an independent predictor of RR
(P < 0.0001, P = 0.99, and
P = 0.18, respectively). The rate of recoil of torsion, determined wholly noninvasively, provides an isovolumic phase, preload-independent assessment of LV relaxation. Use of this novel parameter should allow the detailed study of diastolic function in
states known to affect filling rates, such as aging, hypertension, and
congestive heart failure.
diastole; hemodynamics; magnetic resonance imaging; imaging
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