This Article Full Text Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Little, W. C. Articles by Cheng, C.-P. Search for Related Content PubMed PubMed Citation Articles by Little, W. C. Articles by Cheng, C.-P.

(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.

William C. Little, MD; Michiya Ohno, MD; Dalane W. Kitzman, MD; James D. Thomas, MD; Che-Ping Cheng, MD, PhD

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 (K_LV) would be clinically useful. Our theoretical analysis predicts that K_LV can be calculated from the time for deceleration of LV early filling (t_dec) by

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. K_LV was determined as the slope of the late diastolic portion of the LV P-V loop. K_LV 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 K_LV=(0.08/t_dec)² . The LV filling pattern was determined from the derivative of LV volume (dV/dt). t_dec was measured from peak early filling to the end of early filling. Predicted K_LV and actual K_LV 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 t_dec and K_LV. t_dec 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. K_LV-calculated t_dec from the corrected Doppler t_dec provided a good estimate of measured K_LV (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

This article has been cited by other articles:

				A. Rossi, P. L. Temporelli, M. Quintana, F. L. Dini, S. Ghio, G. S. Hillis, A. L. Klein, N. Ajmone Marsan, D. L. Prior, C. M. Yu, et al. Independent relationship of left atrial size and mortality in patients with heart failure: an individual patient meta-analysis of longitudinal data (MeRGE Heart Failure) Eur J Heart Fail, October 1, 2009; 11(10): 929 - 936. [Abstract] [Full Text] [PDF]

				W. C. Little and J. K. Oh Echocardiographic Evaluation of Diastolic Function Can Be Used to Guide Clinical Care Circulation, September 1, 2009; 120(9): 802 - 809. [Full Text] [PDF]

				Y. T. Tan, F. Wenzelburger, E. Lee, G. Heatlie, F. Leyva, K. Patel, M. Frenneaux, and J. E. Sanderson The pathophysiology of heart failure with normal ejection fraction exercise echocardiography reveals complex abnormalities of both systolic and diastolic ventricular function involving torsion, untwist, and longitudinal motion. J. Am. Coll. Cardiol., June 30, 2009; 54(1): 36 - 46. [Abstract] [Full Text] [PDF]

				Y. Notomi and J. D. Thomas Presto Untwisting and Legato Filling J. Am. Coll. Cardiol. Img., June 1, 2009; 2(6): 717 - 719. [Full Text] [PDF]

				A. Opdahl, E. W. Remme, T. Helle-Valle, E. Lyseggen, T. Vartdal, E. Pettersen, T. Edvardsen, and O. A. Smiseth Determinants of Left Ventricular Early-Diastolic Lengthening Velocity: Independent Contributions From Left Ventricular Relaxation, Restoring Forces, and Lengthening Load Circulation, May 19, 2009; 119(19): 2578 - 2586. [Abstract] [Full Text] [PDF]

				S. F. Nagueh, C. P. Appleton, T. C. Gillebert, P. N. Marino, J. K. Oh, O. A. Smiseth, A. D. Waggoner, F. A. Flachskampf, P. A. Pellikka, and A. Evangelisa Recommendations for the Evaluation of Left Ventricular Diastolic Function by Echocardiography Eur J Echocardiogr, March 1, 2009; 10(2): 165 - 193. [Full Text] [PDF]

				B. Lopez, R. Querejeta, A. Gonzalez, J. Beaumont, M. Larman, and J. Diez Impact of Treatment on Myocardial Lysyl Oxidase Expression and Collagen Cross-Linking in Patients With Heart Failure Hypertension, February 1, 2009; 53(2): 236 - 242. [Abstract] [Full Text] [PDF]

				S. Masutani, W. C. Little, H. Hasegawa, H.-J. Cheng, and C.-P. Cheng Response to Letter Regarding Article, "Restrictive Left Ventricular Filling Pattern Does Not Result From Increased Left Atrial Pressure Alone" Circulation, September 23, 2008; 118(13): e506 - e506. [Full Text] [PDF]

				Meta-analysis Research Group in Echocardiography ( Independence of restrictive filling pattern and LV ejection fraction with mortality in heart failure: An individual patient meta-analysis Eur J Heart Fail, August 1, 2008; 10(8): 786 - 792. [Abstract] [Full Text] [PDF]

				D. Akkan, J. Kjaergaard, J. E. Moller, C. Hassager, C. Torp-Pedersen, L. Kober, and EchoCardiography and Heart Outcome Study (ECHOS) i Prognostic importance of a short deceleration time in symptomatic congestive heart failure Eur J Heart Fail, July 1, 2008; 10(7): 689 - 695. [Abstract] [Full Text] [PDF]

				B. Pinamonti, A. Di Lenarda, G. Nucifora, D. Gregori, A. Perkan, and G. Sinagra Incremental prognostic value of restrictive filling pattern in hypertrophic cardiomyopathy: a Doppler echocardiographic study Eur J Echocardiogr, July 1, 2008; 9(4): 466 - 471. [Abstract] [Full Text] [PDF]

				W. Zhang and S. J. Kovacs The diastatic pressure-volume relationship is not the same as the end-diastolic pressure-volume relationship Am J Physiol Heart Circ Physiol, June 1, 2008; 294(6): H2750 - H2760. [Abstract] [Full Text] [PDF]

				Meta-Analysis Research Group in Echocardiography ( Independent Prognostic Importance of a Restrictive Left Ventricular Filling Pattern After Myocardial Infarction: An Individual Patient Meta-Analysis: Meta-Analysis Research Group in Echocardiography Acute Myocardial Infarction Circulation, May 20, 2008; 117(20): 2591 - 2598. [Abstract] [Full Text] [PDF]

				S. Masutani, W. C. Little, H. Hasegawa, H.-J. Cheng, and C.-P. Cheng Restrictive Left Ventricular Filling Pattern Does Not Result From Increased Left Atrial Pressure Alone Circulation, March 25, 2008; 117(12): 1550 - 1554. [Abstract] [Full Text] [PDF]

				W. A. Jaber, C. S. P. Lam, D. M. Meyer, and M. M. Redfield Revisiting methods for assessing and comparing left ventricular diastolic stiffness: impact of relaxation, external forces, hypertrophy, and comparators Am J Physiol Heart Circ Physiol, November 1, 2007; 293(5): H2738 - H2746. [Abstract] [Full Text] [PDF]

				L. Hatle How to diagnose diastolic heart failure a consensus statement Eur. Heart J., October 2, 2007; 28(20): 2421 - 2423. [Full Text] [PDF]

				M. Kasner, D. Westermann, P. Steendijk, R. Gaub, U. Wilkenshoff, K. Weitmann, W. Hoffmann, W. Poller, H.-P. Schultheiss, M. Pauschinger, et al. Utility of Doppler Echocardiography and Tissue Doppler Imaging in the Estimation of Diastolic Function in Heart Failure With Normal Ejection Fraction: A Comparative Doppler-Conductance Catheterization Study Circulation, August 7, 2007; 116(6): 637 - 647. [Abstract] [Full Text] [PDF]

				L. Shmuylovich and S. J. Kovacs E-wave deceleration time may not provide an accurate determination of LV chamber stiffness if LV relaxation/viscoelasticity is unknown Am J Physiol Heart Circ Physiol, June 1, 2007; 292(6): H2712 - H2720. [Abstract] [Full Text] [PDF]

				J. A. Flewitt, T. N. Hobson, J. Wang Jr., C. R. Johnston, N. G. Shrive, I. Belenkie, K. H. Parker, and J. V. Tyberg Wave intensity analysis of left ventricular filling: application of windkessel theory Am J Physiol Heart Circ Physiol, June 1, 2007; 292(6): H2817 - H2823. [Abstract] [Full Text] [PDF]

				M. M. Riordan and S. J. Kovacs Stiffness- and relaxation-based quantitation of radial left ventricular oscillations: elucidation of regional diastolic function mechanisms J Appl Physiol, May 1, 2007; 102(5): 1862 - 1870. [Abstract] [Full Text] [PDF]

				Y. Wu and S. J. Kovacs Frequency-based analysis of the early rapid filling pressure-flow relation elucidates diastolic efficiency mechanisms Am J Physiol Heart Circ Physiol, December 1, 2006; 291(6): H2942 - H2949. [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]

				C. S. Chung, A. Strunc, R. Oliver, and S. J. Kovacs Diastolic ventricular-vascular stiffness and relaxation relation: elucidation of coupling via pressure phase plane-derived indexes Am J Physiol Heart Circ Physiol, November 1, 2006; 291(5): H2415 - H2423. [Abstract] [Full Text] [PDF]

				S. Klotz, I. Hay, M. L. Dickstein, G.-H. Yi, J. Wang, M. S. Maurer, D. A. Kass, and D. Burkhoff Single-beat estimation of end-diastolic pressure-volume relationship: a novel method with potential for noninvasive application Am J Physiol Heart Circ Physiol, July 1, 2006; 291(1): H403 - H412. [Abstract] [Full Text] [PDF]

				J. K. Oh, L. Hatle, A. J. Tajik, and W. C. Little Diastolic Heart Failure Can Be Diagnosed by Comprehensive Two-Dimensional and Doppler Echocardiography J. Am. Coll. Cardiol., February 7, 2006; 47(3): 500 - 506. [Abstract] [Full Text] [PDF]

				C. S. Chung, D. M. Ajo, and S. J. Kovacs Isovolumic pressure-to-early rapid filling decay rate relation: model-based derivation and validation via simultaneous catheterization echocardiography J Appl Physiol, February 1, 2006; 100(2): 528 - 534. [Abstract] [Full Text] [PDF]

				J. O. Hunderi, C. R. Thompson, and O. A. Smiseth Deceleration time of systolic pulmonary venous flow: a new clinical marker of left atrial pressure and compliance J Appl Physiol, February 1, 2006; 100(2): 685 - 689. [Abstract] [Full Text] [PDF]

				S. Rex, S. Brose, S. Metzelder, L. de Rossi, S. Schroth, R. Autschbach, R. Rossaint, and W. Buhre Normothermic Beating Heart Surgery with Assistance of Miniaturized Bypass Systems: The Effects on Intraoperative Hemodynamics and Inflammatory Response Anesth. Analg., February 1, 2006; 102(2): 352 - 362. [Abstract] [Full Text] [PDF]

				M. M. Riordan and S. J. Kovacs Quantitation of mitral annular oscillations and longitudinal "ringing" of the left ventricle: a new window into longitudinal diastolic function J Appl Physiol, January 1, 2006; 100(1): 112 - 119. [Abstract] [Full Text] [PDF]

				W. C. Little Diastolic Dysfunction Beyond Distensibility: Adverse Effects of Ventricular Dilatation Circulation, November 8, 2005; 112(19): 2888 - 2890. [Full Text] [PDF]

				A. Rovner, N. L. Greenberg, J. D. Thomas, and M. J. Garcia Relationship of diastolic intraventricular pressure gradients and aerobic capacity in patients with diastolic heart failure Am J Physiol Heart Circ Physiol, November 1, 2005; 289(5): H2081 - H2088. [Abstract] [Full Text] [PDF]

				M. Slama, J. Ahn, M. Peltier, J. Maizel, D. Chemla, J. Varagic, D. Susic, C. Tribouilloy, and E. D. Frohlich Validation of echocardiographic and Doppler indexes of left ventricular relaxation in adult hypertensive and normotensive rats Am J Physiol Heart Circ Physiol, September 1, 2005; 289(3): H1131 - H1136. [Abstract] [Full Text] [PDF]

				K. Uemura, T. Kawada, A. Kamiya, T. Aiba, I. Hidaka, K. Sunagawa, and M. Sugimachi Prediction of circulatory equilibrium in response to changes in stressed blood volume Am J Physiol Heart Circ Physiol, July 1, 2005; 289(1): H301 - H307. [Abstract] [Full Text] [PDF]

				P. A. Grayburn, C. P. Appleton, A. N. DeMaria, B. Greenberg, B. Lowes, J. Oh, J. F. Plehn, P. Rahko, M. St. John Sutton, E. J. Eichhorn, et al. Echocardiographic predictors of morbidity and mortality in patients with advanced heart failure: The Beta-blocker Evaluation of Survival Trial (BEST) J. Am. Coll. Cardiol., April 5, 2005; 45(7): 1064 - 1071. [Abstract] [Full Text] [PDF]

				H. Tachibana, H.-J. Cheng, T. Ukai, A. Igawa, Z.-S. Zhang, W. C. Little, and C.-P. Cheng Levosimendan improves LV systolic and diastolic performance at rest and during exercise after heart failure Am J Physiol Heart Circ Physiol, February 1, 2005; 288(2): H914 - H922. [Abstract] [Full Text] [PDF]

				K. M. Modesto, A. Dispenzieri, S. A. Cauduro, M. Lacy, B. K. Khandheria, P. A. Pellikka, M. Belohlavek, J. B. Seward, R. Kyle, A. J. Tajik, et al. Left atrial myopathy in cardiac amyloidosis: implications of novel echocardiographic techniques Eur. Heart J., January 2, 2005; 26(2): 173 - 179. [Abstract] [Full Text] [PDF]

				I. H. Styliadis, N. I. Gouzoumas, H. I. Karvounis, C. E. Papadopoulos, G. K. Efthimiadis, M. Karamouzis, G. E. Parharidis, and G. E. Louridas Effects of variation of atrioventricular interval on left ventricular diastolic filling dynamics and atrial natriuretic peptide levels in patients with DDD pacing for complete heart block Europace, January 1, 2005; 7(6): 576 - 583. [Abstract] [Full Text] [PDF]

				M. Afanasyeva, D. Georgakopoulos, D. Fairweather, P. Caturegli, D. A. Kass, and N. R. Rose Novel Model of Constrictive Pericarditis Associated With Autoimmune Heart Disease in Interferon-{gamma}-Knockout Mice Circulation, November 2, 2004; 110(18): 2910 - 2917. [Abstract] [Full Text] [PDF]

				S. K. Hamlin, P. S. Villars, J. T. Kanusky, and A. D. Shaw Role of Diastole in Left Ventricular Function, II: Diagnosis and Treatment Am. J. Crit. Care., November 1, 2004; 13(6): 453 - 466. [Abstract] [Full Text] [PDF]

				A. W. Bowman, P. A. Frihauf, and S. J. Kovacs Time-varying effective mitral valve area: prediction and validation using cardiac MRI and Doppler echocardiography in normal subjects Am J Physiol Heart Circ Physiol, October 1, 2004; 287(4): H1650 - H1657. [Abstract] [Full Text] [PDF]

				P. Marino, G. Faggian, P. Bertolini, A. Mazzucco, and W. C. Little Early mitral deceleration and left atrial stiffness Am J Physiol Heart Circ Physiol, September 1, 2004; 287(3): H1172 - H1178. [Abstract] [Full Text] [PDF]

				B. Lopez, R. Querejeta, A. Gonzalez, E. Sanchez, M. Larman, and J. Diez Effects of loop diuretics on myocardial fibrosis and collagen type I turnover in chronic heart failure J. Am. Coll. Cardiol., June 2, 2004; 43(11): 2028 - 2035. [Abstract] [Full Text] [PDF]

				A Rossi, M Cicoira, G Golia, L Zanolla, L Franceschini, P Marino, M Graziani, and P Zardini Amino-terminal propeptide of type III procollagen is associated with restrictive mitral filling pattern in patients with dilated cardiomyopathy: a possible link between diastolic dysfunction and prognosis Heart, June 1, 2004; 90(6): 650 - 654. [Abstract] [Full Text] [PDF]

				T. Tabata and A. L. Klein Reply J. Am. Coll. Cardiol., March 3, 2004; 43(5): 926 - 926. [Full Text] [PDF]

				W. C. Little Reply J. Am. Coll. Cardiol., March 3, 2004; 43(5): 928 - 928. [Full Text] [PDF]

				M. Slama, J. Ahn, J. Varagic, D. Susic, and E. D. Frohlich Long-term left ventricular echocardiographic follow-up of SHR and WKY rats: effects of hypertension and age Am J Physiol Heart Circ Physiol, January 1, 2004; 286(1): H181 - H185. [Abstract] [Full Text] [PDF]

				N. H. Andersen, S. H. Poulsen, K. Helleberg, P. Ivarsen, S. T. Knudsen, and C. E. Mogensen Impact of Essential Hypertension and Diabetes Mellitus on Left Ventricular Systolic and Diastolic Performance Eur J Echocardiogr, December 1, 2003; 4(4): 306 - 312. [Abstract] [Full Text] [PDF]

				A. Rovner, R. Smith, N. L. Greenberg, E. M. Tuzcu, N. Smedira, H. M. Lever, J. D. Thomas, and M. J. Garcia Improvement in diastolic intraventricular pressure gradients in patients with HOCM after ethanol septal reduction Am J Physiol Heart Circ Physiol, December 1, 2003; 285(6): H2492 - H2499. [Abstract] [Full Text] [PDF]

				I. Loke, I. B. Squire, J. E. Davies, and L. L. Ng Reference ranges for natriuretic peptides for diagnostic use are dependent on age, gender and heart rate Eur J Heart Fail, October 1, 2003; 5(5): 599 - 606. [Abstract] [Full Text] [PDF]

				N. H Andersen, S. T Knudsen, P. L Poulsen, S. H Poulsen, K. Helleberg, H. Eiskjaer, K. W Hansen, T. Bek, and C. E Mogensen Dual blockade with candesartan cilexetil and lisinopril in hypertensive patients with diabetes mellitus: rationale and design Journal of Renin-Angiotensin-Aldosterone System, June 1, 2003; 4(2): 96 - 99. [Abstract] [PDF]

				H. Hasegawa, W. C. Little, M. Ohno, S. Brucks, A. Morimoto, H.-J. Cheng, and C.-P. Cheng Diastolic mitral annular velocityduring the development of heart failure J. Am. Coll. Cardiol., May 7, 2003; 41(9): 1590 - 1597. [Abstract] [Full Text] [PDF]

				J. W.H. Fung, S. K.W. Chan, L. Y.C. Yeung, and J. E. Sanderson Is beta-blockade useful in heart failure patients with atrial fibrillation? An analysis of data from two previously completed prospective trials Eur J Heart Fail, August 1, 2002; 4(4): 489 - 494. [Abstract] [Full Text] [PDF]

				J. Diez, R. Querejeta, B. Lopez, A. Gonzalez, M. Larman, and J. L. Martinez Ubago Losartan-Dependent Regression of Myocardial Fibrosis Is Associated With Reduction of Left Ventricular Chamber Stiffness in Hypertensive Patients Circulation, May 28, 2002; 105(21): 2512 - 2517. [Abstract] [Full Text] [PDF]

				E. Lubien, A. DeMaria, P. Krishnaswamy, P. Clopton, J. Koon, R. Kazanegra, N. Gardetto, E. Wanner, and A. S. Maisel Utility of B-Natriuretic Peptide in Detecting Diastolic Dysfunction: Comparison With Doppler Velocity Recordings Circulation, February 5, 2002; 105(5): 595 - 601. [Abstract] [Full Text] [PDF]

				S. Capomolla, G. Pinna, O. Febo, A. Caporotondi, G. Guazzotti, M. T. La Rovere, M. Gnemmi, A. Mortara, R. Maestri, and F. Cobelli Echo-Doppler mitral flow monitoring: an operative tool to evaluate day-to-day tolerance to and effectiveness of beta-adrenergic blocking agent therapy in patients with chronic heart failure J. Am. Coll. Cardiol., November 15, 2001; 38(6): 1675 - 1684. [Abstract] [Full Text] [PDF]

				J. B. Lisauskas, J. Singh, A. W. Bowman, and S. J. Kovacs Chamber properties from transmitral flow: prediction of average and passive left ventricular diastolic stiffness J Appl Physiol, July 1, 2001; 91(1): 154 - 162. [Abstract] [Full Text] [PDF]

				T. D. Kinnaird, C. R. Thompson, and B. I. Munt The deceleration time of pulmonary venous diastolic flow is more accurate than the pulmonary artery occlusion pressure in predicting left atrial pressure J. Am. Coll. Cardiol., June 15, 2001; 37(8): 2025 - 2030. [Abstract] [Full Text] [PDF]

				P Otasevic, A N Neskovic, Z Popovic, A Vlahovic, D Bojic, M Bojic, and A D Popovic Short early filling deceleration time on day 1 after acute myocardial infarction is associated with short and long term left ventricular remodelling Heart, May 1, 2001; 85(5): 527 - 532. [Abstract] [Full Text]

				Y. Yong, S. F. Nagueh, S. Shimoni, K. Shan, Z.-X. He, M. J. Reardon, G. V. Letsou, J. F. Howell, M. S. Verani, M. A. Quinones, et al. Deceleration Time in Ischemic Cardiomyopathy : Relation to Echocardiographic and Scintigraphic Indices of Myocardial Viability and Functional Recovery After Revascularization Circulation, March 6, 2001; 103(9): 1232 - 1237. [Abstract] [Full Text] [PDF]

				S. Nakatani, M. S. Firstenberg, N. L. Greenberg, P. M. Vandervoort, N. G. Smedira, P. M. McCarthy, and J. D. Thomas Mitral inertance in humans: critical factor in Doppler estimation of transvalvular pressure gradients Am J Physiol Heart Circ Physiol, March 1, 2001; 280(3): H1340 - H1345. [Abstract] [Full Text] [PDF]

				M. J. Garcia, M. S. Firstenberg, N. L. Greenberg, N. Smedira, L. Rodriguez, D. Prior, and J. D. Thomas Estimation of left ventricular operating stiffness from Doppler early filling deceleration time in humans Am J Physiol Heart Circ Physiol, February 1, 2001; 280(2): H554 - H561. [Abstract] [Full Text] [PDF]

				S. K. Gandhi, J. C. Powers, A.-M. Nomeir, K. Fowle, D. W. Kitzman, K. M. Rankin, and W. C. Little The Pathogenesis of Acute Pulmonary Edema Associated with Hypertension N. Engl. J. Med., January 4, 2001; 344(1): 17 - 22. [Abstract] [Full Text] [PDF]

				M. S. Firstenberg, P. M. Vandervoort, N. L. Greenberg, N. G. Smedira, P. M. McCarthy, M. J. Garcia, and J. D. Thomas Noninvasive estimation of transmitral pressure drop across the normal mitral valve in humans: importance of convective and inertial forces during left ventricular filling J. Am. Coll. Cardiol., November 15, 2000; 36(6): 1942 - 1949. [Abstract] [Full Text] [PDF]

				J. E. Sanderson, S. K. W. Chan, G. Yip, L. Y. C. Yeung, K. W. Chan, K. Raymond, and K. S. Woo Beta-blockade in heart failure: A comparison of carvedilol with metoprolol J. Am. Coll. Cardiol., November 1, 1999; 34(5): 1522 - 1528. [Abstract] [Full Text] [PDF]

				A. Yamamuro, K. Yoshida, T. Hozumi, T. Akasaka, T. Takagi, S. Kaji, T. Kawamoto, and J. Yoshikawa Noninvasive evaluation of pulmonary capillary wedge pressure in patients with acute myocardial infarction by deceleration time of pulmonary venous flow velocity in diastole J. Am. Coll. Cardiol., July 1, 1999; 34(1): 90 - 94. [Abstract] [Full Text] [PDF]

				G. Cerisano, L. Bolognese, N. Carrabba, P. Buonamici, G. M. Santoro, D. Antoniucci, A. Santini, G. Moschi, and P. F. Fazzini Doppler-Derived Mitral Deceleration Time : An Early Strong Predictor of Left Ventricular Remodeling After Reperfused Anterior Acute Myocardial Infarction Circulation, January 19, 1999; 99(2): 230 - 236. [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]

				S. B. Solomon, S. D. Nikolic, S. A. Glantz, and E. L. Yellin Left ventricular diastolic function of remodeled myocardium in dogs with pacing-induced heart failure Am J Physiol Heart Circ Physiol, March 1, 1998; 274(3): H945 - H954. [Abstract] [Full Text] [PDF]

				P. P de Tombe Altered contractile function in heart failure Cardiovasc Res, February 1, 1998; 37(2): 367 - 380. [Abstract] [Full Text] [PDF]

				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]

				B. C. Knollmann, S. A. Blatt, K. Horton, F. de Freitas, T. Miller, M. Bell, P. R. Housmans, N. J. Weissman, M. Morad, and J. D. Potter Inotropic Stimulation Induces Cardiac Dysfunction in Transgenic Mice Expressing a Troponin T (I79N) Mutation Linked to Familial Hypertrophic Cardiomyopathy J. Biol. Chem., March 23, 2001; 276(13): 10039 - 10048. [Abstract] [Full Text] [PDF]

				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]