Document Detail


Relationship of pulmonary vein flow to left ventricular short-axis epicardial displacement in diastole: model-based prediction with in vivo validation.
MedLine Citation:
PMID:  16603684     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Previous studies in healthy humans have established that the (approximately 850 ml) volume enclosed by the pericardial sac is nearly constant over the cardiac cycle, exhibiting a transient approximately 5% decrease (approximately 40 ml) from end diastole to end systole. This volume decrease manifests as a "crescent" at the ventricular free wall level when short-axis MRI images of the epicardial surface acquired at end systole and end diastole are superimposed. On the basis of the (near) constant-volume property of the four-chambered heart, the volume decrease ("crescent effect") must be restored during subsequent early diastolic filling via the left atrial conduit volume. Therefore, volume conservation-based modeling predicts that pulmonary venous (PV) Doppler D-wave volume must be causally related to the radial displacement of the epicardium (Delta) (i.e., magnitude of "crescent effect" in the radial direction). We measured Delta from M-mode echocardiographic images and measured D-wave velocity-time integral (VTI) from Doppler PV flow of the right superior PV in 11 subjects with catheterization-determined normal physiology. In accordance with model prediction, high correlation was observed between Delta and D-wave VTI (r=0.86) and early D-wave VTI measured to peak D-wave velocity (r=0.84). Furthermore, selected subjects with various pathological conditions had values of Delta that differed significantly. These observations demonstrate the volume conservation-based causal relationship between radial pericardial displacement of the left ventricle and the PV D-wave-generated filling volume in healthy subjects as well as the potential role of the M-mode echo-derived radial epicardial displacement index Delta as a regional (radial) parameter of diastolic function.
Authors:
Matt M Riordan; Sándor J Kovács
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Validation Studies     Date:  2006-04-07
Journal Detail:
Title:  American journal of physiology. Heart and circulatory physiology     Volume:  291     ISSN:  0363-6135     ISO Abbreviation:  Am. J. Physiol. Heart Circ. Physiol.     Publication Date:  2006 Sep 
Date Detail:
Created Date:  2006-08-10     Completed Date:  2006-09-26     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  100901228     Medline TA:  Am J Physiol Heart Circ Physiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  H1210-5     Citation Subset:  IM    
Affiliation:
Department of Internal Medicine, Cardiovascular Biophysics Laboratory, Washington University School of Medicine, St. Louis, MO 63110, USA.
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MeSH Terms
Descriptor/Qualifier:
Coronary Circulation / physiology
Diastole / physiology*
Echocardiography
Echocardiography, Doppler
Heart Ventricles / anatomy & histology,  pathology
Humans
Hypertrophy, Left Ventricular / pathology,  physiopathology
Magnetic Resonance Imaging
Middle Aged
Mitral Valve Insufficiency / pathology,  physiopathology
Models, Cardiovascular
Models, Theoretical*
Pericardium / anatomy & histology,  pathology,  physiology*
Pulmonary Veins / anatomy & histology,  pathology,  physiology*
Ventricular Function*
Grant Support
ID/Acronym/Agency:
HL-04023/HL/NHLBI NIH HHS; HL-54179/HL/NHLBI NIH HHS

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