Circulation, Vol 78, 672-683, Copyright © 1988 by American Heart Association
CY Choong, VM Abascal, JD Thomas, JL Guerrero, S McGlew and AE Weyman
The relation of the Doppler transmitral flow velocity profile to left
ventricular loading conditions and diastolic properties remains poorly
described. We studied seven adult mongrel dogs with an open-chest right
heart bypass model in which left atrial pressure, representing preload, was
varied by controlling blood flow into the pulmonary artery and left
ventricular systolic pressure, representing afterload, was controlled
independently by pumping blood into or from the femoral arteries. Heart
rate was kept constant by crushing the sinus node and pacing the right
atrium. Mitral inflow velocity profiles were measured by pulsed-wave
Doppler echocardiography at multiple left atrial and left ventricular
systolic pressures. In individual dogs, the peak E-wave velocity increased
linearly with increasing left atrial V-wave pressure at constant left
ventricular systolic pressure and decreased with increasing left
ventricular systolic pressure at constant left atrial pressure. Stepwise
multiple linear regression analysis of data pooled from all experimental
stages in all dogs identified left atrial V-wave pressure, the time
constant of relaxation (TL), and left ventricular systolic pressure, in
order of decreasing significance, as predictors of the peak E-wave velocity
(n = 82, multiple r = 0.87, p less than 0.0001). Multivariate analysis with
the same three factors in individual dogs yielded higher r values (mean r =
0.89; range, 0.85- 0.97), suggesting the presence of important interdog
differences that were not accounted for by these three factors alone. When
the values of codeterminant hemodynamic factors were kept within narrower
limits, correlations between peak E-wave velocity and left atrial V-wave
pressure (n = 35, multiple r = 0.83, p less than 0.0001), TL (n = 76,
multiple r = -0.54, p less than 0.0001) and left ventricular systolic
pressure (n = 20, multiple r = -0.59, p less than 0.005) improved
substantially. In the pooled data, the relation of the peak E-wave velocity
to left atrial V-wave pressure was shifted downward by an increase in TL
(reduced relaxation rate), and the relation of the peak E-wave velocity to
TL was shifted upward by an increase in left atrial V-wave pressure.
Multivariate analysis also selected left atrial V-wave pressure and TL as
the two most significant correlates of the velocity- time integral and
deceleration rate of the E wave.(ABSTRACT TRUNCATED AT 400 WORDS)
ARTICLES
Combined influence of ventricular loading and relaxation on the transmitral flow velocity profile in dogs measured by Doppler echocardiography
Department of Medicine, Massachusetts General Hospital, Boston 02114.
This article has been cited by other articles:
 |
|
 |
|
  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]
|
|
|
|
 |
|
 T. A. Abd El-Aziz A-Wave Acceleration: A New Doppler Echocardiographic Index for Evaluation of Left Ventricular Diastolic Dysfunction in Elderly Patients Angiology, August 1, 2008; 59(4): 435 - 441. [Abstract] [PDF]
|
|
|
|
 |
|
 P. Lindqvist, G. Wikstrom, and A. Waldenstrom The use of E/Em and the time interval difference of isovolumic relaxation (TIVRT-IVRTm) in estimating left ventricular filling pressures Eur J Heart Fail, May 1, 2008; 10(5): 490 - 497. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. A. Dorfman, B. D. Rosen, M. A. Perhonen, T. Tillery, R. McColl, R. M. Peshock, and B. D. Levine Diastolic suction is impaired by bed rest: MRI tagging studies of diastolic untwisting J Appl Physiol, April 1, 2008; 104(4): 1037 - 1044. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Steine, J. R. Larsen, M. Stugaard, T. J. Berg, M. Brekke, and K. Dahl-Jorgensen LV systolic impairment in patients with asymptomatic coronary heart disease and type 1 diabetes is related to coronary atherosclerosis, glycaemic control and advanced glycation endproducts Eur J Heart Fail, October 1, 2007; 9(10): 1044 - 1050. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Cortina, J. Bermejo, R. Yotti, M. M. Desco, D. Rodriguez-Perez, J. C. Antoranz, J. L. Rojo-Alvarez, D. Garcia, M. A. Garcia-Fernandez, and F. Fernandez-Aviles Noninvasive Assessment of the Right Ventricular Filling Pressure Gradient Circulation, August 28, 2007; 116(9): 1015 - 1023. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Y. Sun, I. Belenkie, J.-J. Wang, and J. V. Tyberg Assessment of right ventricular diastolic suction in dogs with the use of wave intensity analysis Am J Physiol Heart Circ Physiol, December 1, 2006; 291(6): H3114 - H3121. [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]
|
|
|
|
|
|
S. Ghio, G. Magrini, A. Serio, C. Klersy, A. Fucilli, A. Ronaszeki, P. Karpati, G. Mordenti, A. Capriati, P. A. Poole-Wilson, et al. Effects of nebivolol in elderly heart failure patients with or without systolic left ventricular dysfunction: results of the SENIORS echocardiographic substudy Eur. Heart J., March 1, 2006; 27(5): 562 - 568. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Z. Wang, F. Jalali, Y.-H. Sun, J.-J. Wang, K. H. Parker, and J. V. Tyberg Assessment of left ventricular diastolic suction in dogs using wave-intensity analysis Am J Physiol Heart Circ Physiol, April 1, 2005; 288(4): H1641 - H1651. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Reboul, S. Tanguy, J. M. Juan, M. Dauzat, and P. Obert Cardiac remodeling and functional adaptations consecutive to altitude training in rats: implications for sea level aerobic performance J Appl Physiol, January 1, 2005; 98(1): 83 - 92. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. C. Jacques, M. R. Pinsky, D. Severyn, and J. Gorcsan III Influence of Alterations in Loading on Mitral Annular Velocity by Tissue Doppler Echocardiography and Its Associated Ability To Predict Filling Pressures Chest, December 1, 2004; 126(6): 1910 - 1918. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. E. Meyer, M. Karamanoglu, A. A. Ehsani, and S. J. Kovacs Left ventricular chamber stiffness at rest as a determinant of exercise capacity in heart failure subjects with decreased ejection fraction J Appl Physiol, November 1, 2004; 97(5): 1667 - 1672. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. M. Koelling, G. W. Dec, L. C. Ginns, and M. J. Semigran Left Ventricular Diastolic Function in Patients With Advanced Cystic Fibrosis Chest, May 1, 2003; 123(5): 1488 - 1494. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. Bajraktari, S. Qirko, R. Fusco, A. Milazzo, B. Xhaxho, and A. Pezzano Transmitral pulsed-Doppler echocardiography is a more accurate technique compared with two-dimensional echocardiography using dobutamine, in patients with one vessel coronary artery disease Eur J Heart Fail, January 1, 2003; 5(1): 63 - 72. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. Prunier, R. Gaertner, L. Louedec, J.-B. Michel, J.-J. Mercadier, and B. Escoubet Doppler echocardiographic estimation of left ventricular end-diastolic pressure after MI in rats Am J Physiol Heart Circ Physiol, July 1, 2002; 283(1): H346 - H352. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 F Yalcin, A Kaftan, H Muderrisoglu, M E Korkmaz, F Flachskampf, M Garcia, and J D Thomas Is Doppler tissue velocity during early left ventricular filling preload independent? Heart, April 1, 2002; 87(4): 336 - 339. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. S. Firstenberg, N. L. Greenberg, M. L. Main, J. K. Drinko, J. A. Odabashian, J. D. Thomas, and M. J. Garcia Determinants of diastolic myocardial tissue Doppler velocities: influences of relaxation and preload J Appl Physiol, January 1, 2001; 90(1): 299 - 307. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. F. Nagueh, H. Sun, H. A. Kopelen, K. J. Middleton, and D. S. Khoury Hemodynamic determinants of the mitral annulus diastolic velocities by tissue Doppler J. Am. Coll. Cardiol., January 1, 2001; 37(1): 278 - 285. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. S. Firstenberg, B. D. Levine, M. J. Garcia, N. L. Greenberg, L. Cardon, A. J. Morehead, J. Zuckerman, and J. D. Thomas Relationship of echocardiographic indices to pulmonary capillary wedge pressures in healthy volunteers J. Am. Coll. Cardiol., November 1, 2000; 36(5): 1664 - 1669. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Barbier, S. Solomon, N. B. Schiller, and S. A. Glantz Determinants of forward pulmonary vein flow: An open pericardium pig model J. Am. Coll. Cardiol., June 1, 2000; 35(7): 1947 - 1959. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. J. Garcia, N. G. Smedira, N. L. Greenberg, M. Main, M. S. Firstenberg, J. Odabashian, and J. D. Thomas Color M-mode Doppler flow propagation velocity is a preload insensitive index of left ventricular relaxation: animal and human validation J. Am. Coll. Cardiol., January 1, 2000; 35(1): 201 - 208. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. Gonzalez-Vilchez, M. Ares, J. Ayuela, and L. Alonso Combined use of pulsed and color M-mode doppler echocardiography for the estimation of pulmonary capillary wedge pressure: an empirical approach based on an analytical relation J. Am. Coll. Cardiol., August 1, 1999; 34(2): 515 - 523. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Tanaka, K. Mizushige, H. Masugata, H. Matsuo, and K. Mizushige Prolongation of Left Atrial Augmentation After Handgrip Stress in Coronary Artery Disease: Observation Using Pulsed Doppler Flowmetry Angiology, April 1, 1999; 50(4): 299 - 308. [Abstract] [PDF]
|
|
|
|
|
|
S. B. Solomon, P. Barbier, and S. A. Glantz Changes in porcine transmitral flow velocity pattern and its diastolic determinants during partial coronary occlusion J. Am. Coll. Cardiol., March 1, 1999; 33(3): 854 - 866. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. J. Garcia, J. D. Thomas, and A. L. Klein New Doppler echocardiographic applications for the study of diastolic function J. Am. Coll. Cardiol., October 1, 1998; 32(4): 865 - 875. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Mizushige, H. Masugata, H. Morita, S. Senda, H. Matsuo, and K. Mizushige Left Ventricular Diastolic Filling Dynamics During Isometric Exertion in Syndrome X Assessed with Doppler Flowmetry Angiology, October 1, 1997; 48(10): 871 - 881. [Abstract] [PDF]
|
|
|
|
 |
|
 S. J. Kovacs, J. Rosado, A. L. M. McGuire, and A. F. Hall Can Transmitral Doppler E-Waves Differentiate Hypertensive Hearts From Normal? Hypertension, October 1, 1997; 30(4): 788 - 795. [Abstract] [Full Text]
|
|
|
|
|
|
Y. Otsuji, M. D. Handschumacher, E. Schwammenthal, L. Jiang, J.-K. Song, J. L. Guerrero, G. J. Vlahakes, and R. A. Levine Insights From Three-Dimensional Echocardiography Into the Mechanism of Functional Mitral Regurgitation : Direct In Vivo Demonstration of Altered Leaflet Tethering Geometry Circulation, September 16, 1997; 96(6): 1999 - 2008. [Abstract] [Full Text]
|
|
|
|
 |
|
 L. E. Shapiro, R. Sievert, L. Ong, E. L. Ocampo, R. A. Chance, M. Lee, M. Nanna, K. Ferrick, and M. I. Surks Minimal Cardiac Effects in Asymptomatic Athyreotic Patients Chronically Treated with Thyrotropin-Suppressive Doses of L-Thyroxine J. Clin. Endocrinol. Metab., August 1, 1997; 82(8): 2592 - 2595. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. F. Nagueh, H. A. Kopelen, and M. A. Quinones Assessment of Left Ventricular Filling Pressures by Doppler in the Presence of Atrial Fibrillation Circulation, November 1, 1996; 94(9): 2138 - 2145. [Abstract] [Full Text]
|
|
|
|
|
|
R. Belardinelli, D. Georgiou, G. Cianci, N. Berman, L. Ginzton, and A. Purcaro Exercise Training Improves Left Ventricular Diastolic Filling in Patients With Dilated Cardiomyopathy : Clinical and Prognostic Implications Circulation, June 1, 1995; 91(11): 2775 - 2784. [Abstract] [Full Text]
|
|
|
|
|
|
B. Greenberg, M. A. Quinones, C. Koilpillai, M. Limacher, D. Shindler, C. Benedict, and B. Shelton Effects of Long-term Enalapril Therapy on Cardiac Structure and Function in Patients With Left Ventricular Dysfunction : Results of the SOLVD Echocardiography Substudy Circulation, May 15, 1995; 91(10): 2573 - 2581. [Abstract] [Full Text]
|
|
|
|
|
|
K. Yamamoto, T. Masuyama, Y. Doi, J. Naito, T. Mano, H. Kondo, R. Nagano, J. Tanouchi, M. Hori, and T. Kamada Noninvasive Assessment of Left Ventricular Relaxation Using Continuous-Wave Doppler Aortic Regurgitant Velocity Curve : Its Comparative Value to the Mitral Regurgitation Method Circulation, January 1, 1995; 91(1): 192 - 200. [Abstract] [Full Text]
|
|