(Circulation. 1995;92:1933-1939.)
© 1995 American Heart Association, Inc.
Articles |
Determination of Left Ventricular Chamber Stiffness From the Time for Deceleration of Early Left Ventricular Filling
Presented in part at the American Heart Association Scientific Sessions, Dallas, Tex, November 1994.
From the Cardiology Section, Bowman Gray School of Medicine of Wake Forest University, Winston-Salem, NC; and the Cardiovascular Imaging Center (J.D.T.), Department of Cardiology, the Cleveland Clinic Foundation, Cleveland, Ohio.
Correspondence to William C. Little, MD, Cardiology Section, Bowman Gray School of Medicine, Medical Center Blvd, Winston-Salem, NC 27157-1045.
Background A noninvasive measure of left ventricular (LV) chamber stiffness (KLV) would be clinically useful. Our theoretical analysis predicts that KLV can be calculated from the time for deceleration of LV early filling (tdec) by
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where 
=density of blood, L=effective mitral length, and
A=mitral area.
Methods and Results We tested this hypothesis in eight
conscious dogs instrumented for measurement of LV pressure (P) with use
of a micromanometer and volume (V) with use of
sonomicrometers. KLV was determined as the
slope of the late diastolic portion of the LV P-V loop.
KLV was varied from 0.99±0.35 to 2.58±0.92 mm Hg/mL with
use of three graded doses of phenylephrine. We assumed that
=1.0 and that L/A=3.4. Thus, we predicted that
KLV=(0.08/tdec)2 . The LV filling
pattern was determined from the derivative of LV volume (dV/dt).
tdec was measured from peak early filling to the end of
early filling. Predicted KLV and actual KLV
were closely correlated (r=.94, SEE=0.06 mm Hg/mL,
P<.05). The regression line was close to the line of
identity (slope=0.95, intercept=0.13 mm Hg/mL). Dobutamine
did not alter the relation between tdec and
KLV. tdec determined from the mitral valve flow
velocity measured with Doppler echocardiography
correlated well with that measured by dV/dt (r=.89,
P<.01) but was 0.02 seconds longer.
KLV-calculated tdec from the corrected
Doppler tdec provided a good estimate of measured
KLV (r=.75, SEE=0.5 mm Hg/mL,
P<.01).
Conclusions LV chamber stiffness can be determined from the time for deceleration of LV early filling, which can be measured noninvasively.
Key Words: ventricles • chamber stiffness
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B. Andersson, K. Caidahl, A. di Lenarda, S. E. Warren, F. Goss, A. Waldenstrom, S. Persson, I. Wallentin, A. Hjalmarson, and F. Waagstein Changes in Early and Late Diastolic Filling Patterns Induced by Long-term Adrenergic ß-Blockade in Patients With Idiopathic Dilated Cardiomyopathy Circulation, August 15, 1996; 94(4): 673 - 682. [Abstract] [Full Text]
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K. Wachtell, J. N. Bella, J. Rokkedal, V. Palmieri, V. Papademetriou, B. Dahlof, T. Aalto, E. Gerdts, and R. B. Devereux Change in Diastolic Left Ventricular Filling After One Year of Antihypertensive Treatment: The Losartan Intervention For Endpoint Reduction in Hypertension (LIFE) Study Circulation, March 5, 2002; 105(9): 1071 - 1076. [Abstract] [Full Text] [PDF]
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