Document Detail

Tissue Doppler-derived myocardial acceleration for evaluation of left ventricular diastolic function.
MedLine Citation:
PMID:  15464328     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: Our purpose was to evaluate a tissue Doppler-based index-peak myocardial acceleration (pACC)-during isovolumic relaxation and in evaluating left ventricular (LV) diastolic function. BACKGROUND: Simple, practical indexes for diastolic function evaluation are lacking, but are much desired for clinical evaluation. METHODS: We examined eight sheep by using tissue Doppler ultrasound images obtained in the apical four-chamber views to evaluate mitral valve annular velocity at the septum and LV wall. The pACC thus derived was analyzed during isovolumic relaxation (IVRT) and during the LV filling period (LVFP). We then changed the hemodynamic status of each animal by blood administration, dobutamine, and metoprolol infusion. We compared the pACC values during IVRT and LVFP over the four different hemodynamic conditions with a peak rate of drop in LV pressure (-dP/dt(min)) and the time constant of LV isovolumic pressure decay (tau), as measured with a high-frequency manometer-tipped catheter. RESULTS: The pACC of the septal side of the mitral valve annulus during IVRT showed a good correlation with -dP/dt(min) (r = -0.80, p < 0.0001) and tau (r = -0.87, p < 0.0001). The mean left atrial pressure (LAP) correlated well with the septal side pACC during LVFP (r = 0.81, p < 0.0001). There was a weak correlation between the mitral valve annulus pACC at the LV lateral wall and mean LAP. CONCLUSIONS: The pACC during IVRT is a sensitive, preload-independent marker for evaluation of LV diastolic function. In addition, pACC during LVFP correlated well with mean LAP.
Ikuo Hashimoto; Aarti Hejmadi Bhat; Xiaokui Li; Michael Jones; Crispin H Davies; Julia C Swanson; Sebastian T Schindera; David J Sahn
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  44     ISSN:  0735-1097     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  2004 Oct 
Date Detail:
Created Date:  2004-10-06     Completed Date:  2004-10-27     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1459-66     Citation Subset:  AIM; IM    
Clinical Care Center for Congenital Heart Disease, Oregon Health and Science University, Portland, Oregon 97239-3098, USA.
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MeSH Terms
Cardiac Output
Coronary Circulation
Echocardiography, Doppler*
Feasibility Studies
Heart Rate
Heart Ventricles / ultrasonography*
Observer Variation
Ventricular Function, Left*

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