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1 Departments of Cardiac Sciences and Physiology and Biophysics, University of Calgary, Calgary, AB, Canada
2 Imperial College of Science, Technology and Medicine, London, United Kingdom
3 Departments of Cardiac Sciences and Physiology and Biophysics, University of Calgary, Calgary, AB, Canada; Imperial College of Science, Technology and Medicine, London, United Kingdom
* To whom correspondence should be addressed. E-mail: jtyberg{at}ucalgary.ca.
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 (VLVES). We used wave-intensity analysis (WIA)to measure the total energy transported by the backward expansion wave (IW-) during LV relaxation, in an attempt to reconcile these mechanisms. In 6 anesthetized, open-chest dogs, we measured aortic, LV (PLV), LA (PLA), and pericardial pressures and LV volume, by orthogonal ultrasonic crystals. Mitral velocity was measured by Doppler echocardiography and aortic by an ultrasonic flow probe. Heart rate was controlled by pacing, VLVES by volume loading, and by isoproterenol or esmolol administration. IW- was found to be inversely related to and VLVES. Our measure of DS, the energy remaining after mitral valve opening, IW-DS, was also found to be inversely related to and VLVES and was approximately 10% of the total "aspirating" energy generated by LV relaxation (i.e., IW-). The size of the Doppler (early-filling) E-wave depended on IW-DS, in addition to IW+, the energy associated with LA decompression. We concluded that the energy of the backward-going wave generated by the LV during relaxation depends both upon the rate at which elastance decreases (i.e., ) and on VLVES. WIA provides a new approach for assessing DS and reconciles those two previously proposed mechanisms. The E-wave depends upon DS, in addition to LA decompression.
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