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].

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 Noninvasive assessment of ejection intraventricular pressure gradients

2004 ◽  
Vol 43 (9) ◽  
pp. 1654-1662 ◽  
Author(s):  
Raquel Yotti ◽  
Javier Bermejo ◽  
J.Carlos Antoranz ◽  
José Luis Rojo-Álvarez ◽  
Carmen Allue ◽  
...  
Keyword(s):  
Intraventricular Pressure ◽  
Pressure Gradients ◽  
Intraventricular Pressure Gradients ◽  
Noninvasive Assessment

scholarly journals Non-Invasive Assessment of Intravascular Pressure Gradients: A Review of Current and Proposed Novel Methods

Diagnostics ◽  
2018 ◽  
Vol 9 (1) ◽  
pp. 5 ◽  
Author(s):  
Tin-Quoc Nguyen ◽  
Kristoffer Hansen ◽  
Thor Bechsgaard ◽  
Lars Lönn ◽  
Jørgen Jensen ◽  
...  
Keyword(s):  
Stokes Equations ◽  
Imaging Techniques ◽  
Navier Stokes ◽  
Pressure Gradients ◽  
Bernoulli Equation ◽  
Strong Correlations ◽  
Navier Stokes Equations ◽  
Non Invasive ◽  
Invasive Techniques

Invasive catheterization is associated with a low risk of serious complications. However, although it is the gold standard for measuring pressure gradients, it induces changes to blood flow and requires significant resources. Therefore, non-invasive alternatives are urgently needed. Pressure gradients are routinely estimated non-invasively in clinical settings using ultrasound and calculated with the simplified Bernoulli equation, a method with several limitations. A PubMed literature search on validation of non-invasive techniques was conducted, and studies were included if non-invasively estimated pressure gradients were compared with invasively measured pressure gradients in vivo. Pressure gradients were mainly estimated from velocities obtained with Doppler ultrasound or magnetic resonance imaging. Most studies used the simplified Bernoulli equation, but more recent studies have employed the expanded Bernoulli and Navier–Stokes equations. Overall, the studies reported good correlation between non-invasive estimation of pressure gradients and catheterization. Despite having strong correlations, several studies reported the non-invasive techniques to either overestimate or underestimate the invasive measurements, thus questioning the accuracy of the non-invasive methods. In conclusion, more advanced imaging techniques may be needed to overcome the shortcomings of current methods.

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.

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