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(Circulation. 1997;95:151-155.)
© 1997 American Heart Association, Inc.

Articles

Noninvasive Assessment of the Ventricular Relaxation Time Constant () in Humans by Doppler Echocardiography

Gregory M. Scalia, MBBS, FRACP; Neil L. Greenberg, MSE; Patrick M. McCarthy, MD; James D. Thomas, MD; Pieter M. Vandervoort, MD

the Cardiovascular Imaging Center, Department of Cardiology and Department of Thoracic and Cardiovascular Surgery (P.M.M.), The Cleveland (Ohio) Clinic Foundation.

Correspondence to Pieter Vandervoort, MD, Cardiovascular Imaging Center, Department of Cardiology/F15, The Cleveland Clinic Foundation, 9500 Euclid Ave, Cleveland, OH 44195. E-mail vanderp@cesmtp.ccf.org.

Background The time constant of ventricular relaxation () is a quantitative measure of diastolic performance requiring intraventricular pressure recording. This study validates in humans an equation relating to left ventricular pressure at peak -dP/dt (P₀), pressure at mitral valve opening (P_MV), and isovolumic relaxation time (IVRT_inv). The clinically obtainable parameters peak systolic blood pressure (P_s), mean left atrial pressure (P_LA), and Doppler-derived IVRT (IVRT_Dopp) are then substituted into this equation to obtain _Dopp noninvasively.

Methods and Results High-fidelity left atrial and left ventricular pressure recordings with simultaneous Doppler by transesophageal echocardiography were obtained from 11 patients during cardiac surgery. Direct curve fitting to the left ventricular pressure trace by Levenberg-Marquardt regression assuming a zero asymptote generated _LM, the "gold standard" against which _calc {IVRT_inv/[ln(P₀)-ln(P_MV)]} and _Dopp {IVRT_Dopp/[ln(P_s)-ln(P_LA)]} were compared. For 123 cycles analyzed in 18 hemodynamic states, mean _LM was 53.8±12.9 ms. _calc (51.5±11 ms) correlated closely with this standard (r=.87, SEE=5.5 ms). Noninvasive _Dopp (43.8±11 ms) underestimated _LM but exhibited close linear correlation (n=88, r=.75, SEE=7.5 ms). Substituting P_LA=10 mm Hg into the equation yielded ₁₀ (48.7±15 ms), which also closely correlated with the standard (r=.62, SEE=11.6 ms).

Conclusions The previously obtained analytical expression relating IVRT, invasive pressures, and is valid in humans. Furthermore, a more clinically obtainable, noninvasive method of obtaining also closely predicts this important measure of diastolic function.

Key Words: diastole • echocardiography • ventricles

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