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

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.

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

ASME 2010 Summer Bioengineering Conference, Parts A and B ◽

10.1115/sbc2010-19328 ◽

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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Analysis of inter-system variability of systolic and diastolic intraventricular pressure gradients derived from color Doppler M-mode echocardiography

Scientific Reports ◽

10.1038/s41598-020-64059-4 ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Amir Hodzic ◽

Odile Bonnefous ◽

Hélène Langet ◽

Walid Hamiche ◽

Laure Chaufourier ◽

...

Keyword(s):

Color Doppler ◽

Intraventricular Pressure ◽

Pressure Gradients ◽

Intraventricular Pressure Gradients ◽

System Variability

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Noninvasive Quantification of Intraventricular Pressure Gradients and Flow Propagation From Color Doppler M-Mode Relates to Invasive Pressures in an Ischemic Canine Model

Journal of the American College of Cardiology ◽

10.1016/s0735-1097(97)84938-8 ◽

1998 ◽

Vol 31 (2) ◽

pp. 282A

Author(s):

M Stugaard

Keyword(s):

Color Doppler ◽

Canine Model ◽

Intraventricular Pressure ◽

Pressure Gradients ◽

Intraventricular Pressure Gradients ◽

Flow Propagation

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

AJP Heart and Circulatory Physiology ◽

10.1152/ajpheart.2001.280.6.h2507 ◽

2001 ◽

Vol 280 (6) ◽

pp. H2507-H2515 ◽

Cited By ~ 99

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.

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