MRI Assessment of Diastolic and Systolic Intraventricular Pressure Gradients in Heart Failure

2016 ◽  
Vol 13 (1) ◽  
pp. 37-46 ◽  
Author(s):  
Snigdha Jain ◽  
Francisco J. Londono ◽  
Patrick Segers ◽  
Thierry C. Gillebert ◽  
Marc De Buyzere ◽  
...  
Keyword(s):  
Heart Failure ◽  
Intraventricular Pressure ◽  
Pressure Gradients ◽  
Intraventricular Pressure Gradients

scholarly journals Intraventricular Pressure Gradients in Heart Failure

2013 ◽  
pp. 479-487 ◽  
Author(s):  
M. GUERRA ◽  
C. BRÁS-SILVA ◽  
M. J. AMORIM ◽  
C. MOURA ◽  
P. BASTOS ◽  
...  
Keyword(s):  
Heart Failure ◽  
Minimal Length ◽  
Saline Control ◽  
Control Group ◽  
Intraventricular Pressure ◽  
Pressure Gradients ◽  
Saline Control Group ◽  
Failure Group ◽  
Intraventricular Pressure Gradients ◽  
Ventricular Filling

The aim of the present study was to characterize intraventricular pressure gradients (IVPGs) in an animal model of chronic heart failure. New Zealand rabbits were treated with doxorubicin (heart failure group, n=5) or saline (control group, n=5) and instrumented with pressure catheters placed in the apex and outflow-tract of left ventricle (LV) and with sonomicrometer crystals placed in the apex and base of the LV free wall. In heart failure animals, ventricular filling was delayed and slower when compared with control animals. Moreover, the physiological nonuniformity observed between apical and basal segments in normal hearts was abolished in failing hearts. Simultaneously, physiological IVPGs observed during normal ventricular filling were entirely lost in heart failure animals. During ventricular emptying physiological nonuniformity between apical and basal segments observed in control animals was also abolished in heart failure animals. In failing hearts minimal length occurred later and almost at same time both in apical and in basal myocardial segments. Simultaneously, the characteristic IVPG pattern observed in healthy hearts during systole, which promotes ventricular emptying, was not observed in failing hearts. The present study showed that diastolic IVPGs, a marker of normal ventricular filling, and systolic IVPGs, a marker of normal ventricular emptying, are abolished in heart failure.

Relationship of diastolic intraventricular pressure gradients and aerobic capacity in patients with diastolic heart failure

2005 ◽  
Vol 289 (5) ◽  
pp. H2081-H2088 ◽  
Author(s):  
Aleksandr Rovner ◽  
Neil L. Greenberg ◽  
James D. Thomas ◽  
Mario J. Garcia
Keyword(s):  
Heart Failure ◽  
Diastolic Function ◽  
Aerobic Capacity ◽  
Normal Subjects ◽  
Intraventricular Pressure ◽  
Pressure Gradients ◽  
Suction Force ◽  
Myocardial Relaxation ◽  
Patients With Heart Failure ◽  
Intraventricular Pressure Gradients

We sought to elucidate the relationship between diastolic intraventricular pressure gradients (IVPG) and exercise tolerance in patients with heart failure using color M-mode Doppler. Diastolic dysfunction has been implicated as a cause of low aerobic potential in patients with heart failure. We previously validated a novel method to evaluate diastolic function that involves noninvasive measurement of IVPG using color M-mode Doppler data. Thirty-one patients with heart failure and 15 normal subjects were recruited. Echocardiograms were performed before and after metabolic treadmill stress testing. Color M-mode Doppler was used to determine the diastolic propagation velocity ( Vp) and IVPG off-line. Resting diastolic function indexes including myocardial relaxation velocity, Vp, and E/ Vp correlated well with V̇o2 max ( r = 0.8, 0.5, and −0.5, respectively, P < 0.001 for all). There was a statistically significant increase in Vp and IVPG in both groups after exercise, but the change in IVPG was higher in normal subjects compared with patients with heart failure (2.6 ± 0.8 vs. 1.1 ± 0.8 mmHg, P < 0.05). Increase in IVPG correlated with peak V̇o2 max ( r = 0.8, P < 0.001) and was the strongest predictor of exercise capacity. Myocardial relaxation is an important determinant of exercise aerobic capacity. In heart failure patients, impaired myocardial relaxation is associated with reduced diastolic suction force during exercise.

Abstract 20360: MRI Assessment of Diastolic and Systolic Intraventricular Pressure Gradients in Heart Failure

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Francisco J Londoño ◽  
Patrick Segers ◽  
Prithvi Shiva kumar ◽  
Prasad Konda ◽  
Payman Zamani ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Pressure Gradient ◽  
Diastolic Function ◽  
Diastolic Filling ◽  
Intraventricular Pressure ◽  
Pressure Gradients ◽  
Intraventricular Pressure Gradients ◽  
Intraventricular Pressure Gradient ◽  
Early Filling

Background: Non-invasive assessment of left ventricular (LV) diastolic function is an important goal to better understand physiologic abnormalities in heart failure. The spatiotemporal pattern of LV blood flow velocities during early filling can be used to estimate intraventricular pressure gradients driving early filling. MRI can provide accurate flow velocity information in the LV, but this method has not been exploited to assess diastolic function in heart failure (HF). Aim: To assess differences in intraventricular pressure gradients in heart failure and preserved ejection fraction (HFPEF) and heart failure with reduced ejection fraction (HFREF), compared to subjects without HF. Methods: We studied 23 subjects without HF, 13 subjects with HFREF and 14 subjects with HFPEF. Intraventricular flow during diastole was measured using 2D in-plane phase-contrast MRI. We solved the Eulier equations to compute intraventricular pressure gradients during LV early filling (figure) and during ejection. Results: Whereas the initial velocity of wave propagation (was not significantly different between the groups, the terminal diastolic propagation velocity during early diastolic filling was significantly slower (P=0.004) in HFREF (5.2 m/s; 95%CI=3.9-6.8) than in patients with HFPEF (9.5; 95%CI=6.6-13.6) or subjects without HF (8.9; 95%CI=7.3-10.7). In contrast, HFPEF was associated with a greater amplitude of the reversal of the base-to-apex intraventricular pressure gradient during early filling (β=-0.34; P=0.04), which was driven by the inertial component. Conclusions: HFPEF and HFREF are associated with distinct patterns of intraventricular pressure gradient abnormalities during early diastolic filling. Our findings support fundamental differences in the nature of diastolic dysfunction in these 2 conditions.

scholarly journals EFFECT OF MITRAL INFLOW PATTERN ON INTRAVENTRICULAR PRESSURE GRADIENTS IN HYPERTENSION RATS

2019 ◽  
Vol 37 ◽  
pp. e157-e158
Author(s):  
D. Ma ◽  
K. Matsuura ◽  
K. Takahashi ◽  
K. Shimada ◽  
T. Yoshida ◽  
...  
Keyword(s):  
Intraventricular Pressure ◽  
Pressure Gradients ◽  
Mitral Inflow ◽  
Intraventricular Pressure Gradients

scholarly journals Intraventricular pressure gradients throughout the cardiac cycle: effects of ischaemia and modulation by afterload

2012 ◽  
Vol 98 (1) ◽  
pp. 149-160 ◽  
Author(s):  
Miguel Guerra ◽  
Mário Jorge Amorim ◽  
Cármen Brás-Silva ◽  
Adelino F. Leite-Moreira
Keyword(s):  
Cardiac Cycle ◽  
Intraventricular Pressure ◽  
Pressure Gradients ◽  
Intraventricular Pressure Gradients

Noninvasive Assessment of Diastolic Intraventricular Pressure Gradients in a Large General Population (the Asklepios Study)

2010 ◽  
Author(s):  
Benjamin Van Der Smissen ◽  
Tom E. Claessens ◽  
Ernst R. Rietzschel ◽  
Marc L. De Buyzere ◽  
Dirk De Bacquer ◽  
...  
Keyword(s):  
Intraventricular Pressure ◽  
Pressure Gradients ◽  
Accurate Assessment ◽  
Non Invasive ◽  
Intraventricular Pressure Gradients ◽  
Scan Line ◽  
Noninvasive Assessment ◽  
Prognostic Implications ◽  
Invasive Techniques ◽  
Intraventricular Pressure Gradient

Accurate assessment of diastolic (dys)function by non-invasive techniques has important therapeutic and prognostic implications but remains a challenge to the cardiologist. A promising parameter to evaluate diastolic (dys)function more accurately is the early diastolic intraventricular pressure gradient (IVPGe) which is considered representative of the active relaxation of the left ventricle. It has been shown that IVPGe can be estimated non-invasively by measuring blood velocities along a base-to-apex scan line using color M-mode Doppler (CMD) echography [1]. Although this technique is known for about 20 years, IVPGe is still not used in daily clinical practice because its approach is complicated and too laborious [2].

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