Intraventricular Pressure Gradients in Left Ventricular Aneurysms Determined by Color M-Mode Doppler Method: An Animal Study

2006 ◽  
Vol 19 (9) ◽  
pp. 1112-1118 ◽  
Author(s):  
Junko Asada-Kamiguchi ◽  
Michael Jones ◽  
Neil L. Greenberg ◽  
Zoran B. Popovic ◽  
Hiroyuki Tsujino ◽  
...  
Keyword(s):  
Animal Study ◽  
Left Ventricular ◽  
Intraventricular Pressure ◽  
Pressure Gradients ◽  
Doppler Method ◽  
Intraventricular Pressure Gradients

scholarly journals Estimation of diastolic intraventricular pressure gradients by Doppler M-mode echocardiography

2001 ◽  
Vol 280 (6) ◽  
pp. H2507-H2515 ◽  
Author(s):  
Neil L. Greenberg ◽  
Pieter M. Vandervoort ◽  
Michael S. Firstenberg ◽  
Mario J. Garcia ◽  
James D. Thomas
Keyword(s):  
Euler Equation ◽  
Color Doppler ◽  
Numerical Differentiation ◽  
Left Ventricular ◽  
Diastolic Filling ◽  
Accurate Estimation ◽  
Intraventricular Pressure ◽  
Pressure Gradients ◽  
Adrenergic Stimulation ◽  
Intraventricular Pressure Gradients

Previous studies have shown that small intraventricular pressure gradients (IVPG) are important for efficient filling of the left ventricle (LV) and as a sensitive marker for ischemia. Unfortunately, there has previously been no way of measuring these noninvasively, severely limiting their research and clinical utility. Color Doppler M-mode (CMM) echocardiography provides a spatiotemporal velocity distribution along the inflow tract throughout diastole, which we hypothesized would allow direct estimation of IVPG by using the Euler equation. Digital CMM images, obtained simultaneously with intracardiac pressure waveforms in six dogs, were processed by numerical differentiation for the Euler equation, then integrated to estimate IVPG and the total (left atrial to left ventricular apex) pressure drop. CMM-derived estimates agreed well with invasive measurements (IVPG: y = 0.87 x + 0.22, r = 0.96, P < 0.001, standard error of the estimate = 0.35 mmHg). Quantitative processing of CMM data allows accurate estimation of IVPG and tracking of changes induced by β-adrenergic stimulation. This novel approach provides unique information on LV filling dynamics in an entirely noninvasive way that has previously not been available for assessment of diastolic filling and function.

scholarly journals Doppler-Derived Ejection Intraventricular Pressure Gradients Provide a Reliable Assessment of Left Ventricular Systolic Chamber Function

Circulation ◽  
2005 ◽  
Vol 112 (12) ◽  
pp. 1771-1779 ◽  
Author(s):  
Raquel Yotti ◽  
Javier Bermejo ◽  
M. Mar Desco ◽  
J. Carlos Antoranz ◽  
José Luis Rojo-Álvarez ◽  
...  
Keyword(s):  
Left Ventricular ◽  
Intraventricular Pressure ◽  
Pressure Gradients ◽  
Reliable Assessment ◽  
Intraventricular Pressure Gradients

scholarly journals Relationship Between Early Diastolic Intraventricular Pressure Gradients, an Index of Elastic Recoil, and Improvements in Systolic and Diastolic Function

Circulation ◽  
2001 ◽  
Vol 104 (suppl_1) ◽  
Author(s):  
Michael S. Firstenberg ◽  
Nicholas G. Smedira ◽  
Neil L. Greenberg ◽  
David L. Prior ◽  
Patrick M. McCarthy ◽  
...  
Keyword(s):  
Animal Studies ◽  
Simultaneous Recording ◽  
Left Ventricular ◽  
Lv Function ◽  
Acute Ischemia ◽  
Intraventricular Pressure ◽  
Pressure Gradients ◽  
Elastic Recoil ◽  
Heart Rates ◽  
Intraventricular Pressure Gradients

Background Early diastolic intraventricular pressure gradients (IVPGs) have been proposed to relate to left ventricular (LV) elastic recoil and early ventricular “suction.” Animal studies have demonstrated relationships between IVPGs and systolic and diastolic indices during acute ischemia. However, data on the effects of improvements in LV function in humans and the relationship to IVPGs are lacking. Methods and Results Eight patients undergoing CABG and/or infarct exclusion surgery had a triple-sensor high-fidelity catheter placed across the mitral valve intraoperatively for simultaneous recording of left atrial (LA), basal LV, and apical LV pressures. Hemodynamic data obtained before bypass were compared with those with similar LA pressures and heart rates obtained after bypass. From each LV waveform, the time constant of LV relaxation (τ), +dP/dt max , and −dP/dt max were determined. Transesophageal echocardiography was used to determined end-diastolic (EDV) and end-systolic (ESV) volumes and ejection fractions (EF). At similar LA pressures and heart rates, IVPG increased after bypass (before bypass 1.64±0.79 mm Hg; after bypass 2.67±1.25 mm Hg; P <0.01). Significant improvements were observed in ESV, as well as in apical and basal +dP/dt max , −dP/dt max , and τ (each P <0.05). Overall, IVPGs correlated inversely with both ESV (IVPG=−0.027[ESV]+3.46, r =−0.64) and EDV (IVPG=−0.027[EDV]+4.30, r =−0.70). Improvements in IVPGs correlated with improvements in apical τ (Δτ =5.93[ΔIVPG]+4.76, r =0.91) and basal τ (Δτ =2.41[ΔIVPG]+5.13, r =−0.67). Relative changes in IVPGs correlated with changes in ESV (ΔESV=−0.97[%ΔIVPG]+23.34, r =−0.79), EDV (ΔEDV=−1.16[%ΔIVPG]+34.92, r =−0.84), and EF (ΔEF=0.38[%ΔIVPG]−8.39, r =0.85). Conclusions Improvements in LV function also increase IVPGs. These changes in IVPGs, suggestive of increases in LV suction and elastic recoil, correlate directly with improvements in LV relaxation and ESV.

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

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.

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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