Document Detail


Increase in the late diastolic filling force is associated with impaired transmitral flow efficiency in acute moderate elevation of left ventricular afterload.
MedLine Citation:
PMID:  19168767     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Analysis of intraventricular flow force and efficiency is a novel concept of quantitatively assessing left ventricular (LV) hemodynamic performance. We have parametrically characterized diastolic filling flow by early inflow force, late inflow force, and total inflow force and by vortex formation time (VFT), a fundamental parameter of fluid transport efficiency. The purpose of this study was to determine what changes in inflow forces characterize a decrease in diastolic blood transport efficiency in acute moderate elevation of LV afterload. METHODS: In 8 open-chested pigs, the flow force and VFT parameters were calculated from conventional and flow Doppler echocardiographic measurements at baseline and during a brief (3-minute) moderate elevation of afterload induced by increasing the systolic blood pressure to 130% of the baseline value. RESULTS: Systolic LV function decreased significantly during elevated afterload. Early inflow force did not significantly change, whereas late inflow force increased from 5,822.09 +/- 1,656.5 (mean +/- SD) to 13,948.25 +/- 9,773.96 dyne (P = .049), and total inflow force increased from 13,783.35 +/- 4,816.58 to 21,836.67 +/- 8,635.33 dyne (P = .031). Vortex formation time decreased from 4.09 +/- 0.29 to 2.79 +/- 1.1 (P = .0068), confirming suboptimal flow transport efficiency. CONCLUSIONS: Even a brief moderate increase of LV afterload causes a significant increase in late diastolic filling force and impairs transmitral flow efficiency.
Authors:
Panupong Jiamsripong; Anna M Calleja; Mohsen S Alharthi; Eun Joo Cho; Eileen M McMahon; Jeffrey J Heys; Michele Milano; Partho P Sengupta; Bijoy K Khandheria; Marek Belohlavek
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine     Volume:  28     ISSN:  1550-9613     ISO Abbreviation:  J Ultrasound Med     Publication Date:  2009 Feb 
Date Detail:
Created Date:  2009-01-26     Completed Date:  2009-04-15     Revised Date:  2010-08-09    
Medline Journal Info:
Nlm Unique ID:  8211547     Medline TA:  J Ultrasound Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  175-82     Citation Subset:  IM    
Affiliation:
Division of Cardiovascular Diseases, Translational Ultrasound Research Laboratory, Mayo Clinic Arizona, Scottsdale, Arizona 85259, USA.
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Animals
Blood Flow Velocity*
Blood Pressure*
Hypertrophy, Left Ventricular / complications,  physiopathology*,  ultrasonography*
Image Interpretation, Computer-Assisted / methods*
Swine
Vascular Resistance
Ventricular Dysfunction, Left / etiology,  physiopathology*,  ultrasonography*
Grant Support
ID/Acronym/Agency:
HL68573/HL/NHLBI NIH HHS; R01 HL068573-05/HL/NHLBI NIH HHS

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