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Assessment of left ventricular diastolic suction in dogs using wave-intensity analysis

¹Qingdao University Medical College Hospital, Qingdao, China; ²Cardiovascular Research Group, Department of Cardiac Sciences and Department of Physiology and Biophysics, University of Calgary, Calgary, Alberta, Canada; and ³Department of Bioengineering, Imperial College of Science, Technology and Medicine, London, United Kingdom

Submitted 1 March 2004 ; accepted in final form 18 November 2004

Two apparently different types of mechanisms have emerged to explain diastolic suction (DS), that property of the left ventricle (LV) that tends to cause it to refill itself during early diastole independent of any force from the left atrium (LA). By means of the first mechanism, DS depends on decreased elastance [e.g., the relaxation time constant ()] and, by the second, end-systolic volume (V_LVES). We used wave-intensity analysis (WIA) to measure the total energy transported by the backward expansion wave (I_W–) during LV relaxation in an attempt to reconcile these mechanisms. In six anesthetized, open-chest dogs, we measured aortic, LV (P_LV), LA (P_LA), and pericardial pressures and LV volume by orthogonal ultrasonic crystals. Mitral velocity was measured by Doppler echocardiography, and aortic velocity was measured by an ultrasonic flow probe. Heart rate was controlled by pacing, V_LVES by volume loading, and by isoproterenol or esmolol administration. I_W– was found to be inversely related to and V_LVES. Our measure of DS, the energy remaining after mitral valve opening, I_W–DS, was also found to be inversely related to and V_LVES and was 10% of the total "aspirating" energy generated by LV relaxation (i.e., I_W–). The size of the Doppler (early filling) E wave depended on I_W–DS in addition to I_W+, the energy associated with LA decompression. We conclude that the energy of the backward-going wave generated by the LV during relaxation depends on both the rate at which elastance decreases (i.e., ) and V_LVES. WIA provides a new approach for assessing DS and reconciles those two previously proposed mechanisms. The E wave depends on DS in addition to LA decompression.

diastole; hemodynamics; mitral valve; ventricles

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