Document Detail

Mitral E wave propagation as an index of left ventricular diastolic function. I: Its hydrodynamic basis.
MedLine Citation:
PMID:  9697068     Owner:  NLM     Status:  MEDLINE    
BACKGROUND AND AIMS OF THE STUDY: Left ventricular (LV) diastolic dysfunction is an early sign of myocardial disease and an important determinant of symptoms and prognosis in patients with various cardiovascular disorders. Evidence suggests the presence and clinical importance of abnormal LV diastolic function in patients with valvular heart diseases, but it is difficult to measure non-invasively. Mitral E wave propagation inside the left ventricle studied by analysis of digitized color M-mode and pulsed wave Doppler technique is a promising technique for the evaluation of LV relaxation. However, the precise mechanism of its transmission is not clearly defined. Understanding the precise hydrodynamic basis of E wave propagation would be helpful for its meaningful application to the evaluation of LV diastolic performance. This study investigates the hydrodynamic determinants of mitral E wave propagation in an in vitro setting. METHODS AND RESULTS: Thirty-one sets of experiments were conducted in a linear, pulsatile left ventricle model with varying operative diastolic characteristics. The rate of transmission of the onset of the E wave was strongly related to operative LV diastolic stiffness (r = 0.93, p < 0.0001), and weakly to mean left atrial (LA) pressure (r = 0.46, p < 0.01), heart rate (r = 0.57, p < 0.01) and stroke volume (r = -0.58, p < 0.01) through an effect on operative LV diastolic stiffness. The peak of the E wave transmission was influenced not only by operative LV diastolic stiffness (r = 0.87, p < 0.0001), but also by the mean LA pressure, heart rate and stroke volume, in an independent fashion. CONCLUSIONS: The rate of transmission of the onset of the mitral E wave is determined solely by operative LV diastolic stiffness, whereas that of the peak is also affected by the mean LA pressure, heart rate and stroke volume. Analysis of mitral E wave propagation in patients with valvular heart disease may give clinically useful insights into LV diastolic function.
R G Pai; A P Yoganathan; C Toomes; C Eberhardt; P M Shah
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of heart valve disease     Volume:  7     ISSN:  0966-8519     ISO Abbreviation:  J. Heart Valve Dis.     Publication Date:  1998 Jul 
Date Detail:
Created Date:  1998-10-19     Completed Date:  1998-10-19     Revised Date:  2006-05-04    
Medline Journal Info:
Nlm Unique ID:  9312096     Medline TA:  J Heart Valve Dis     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  438-44     Citation Subset:  IM    
Loma Linda University, California, USA.
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MeSH Terms
Diastole / physiology
Echocardiography, Doppler, Color
Heart Valve Diseases / physiopathology
Mitral Valve / physiology*
Models, Cardiovascular
Pulsatile Flow / physiology
Ventricular Dysfunction, Left / physiopathology
Ventricular Function, Left / physiology*

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