Color M-mode Doppler flow propagation velocity is a preload insensitive index of left ventricular relaxation: Animal and human validation

Mario J. Garcia, Nicholas G. Smedira, Neil L. Greenberg, Michael Main, Michael S. Firstenberg, Jill Odabashian, James D. Thomas

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Abstract

OBJECTIVES: To determine the effect of preload in color M-mode Doppler flow propagation velocity (v(p)). BACKGROUND: The interpretation of Doppler filling patterns is limited by confounding effects of left ventricular (LV) relaxation and preload. Color M-mode v(p) has been proposed as a new index of LV relaxation. METHODS: We studied four dogs before and during inferior caval (IVC) occlusion at five different inotropic stages and 14 patients before and during partial cardiopulmonary bypass. Left ventricular (LV) end-diastolic volumes (LV-EDV), the time constant of isovolumic relaxation (tau), left atrial (LA) pre-A and LV end-diastolic pressures (LV-EDP) were measured. Peak velocity during early filling (E) and v(p) were extracted by digital analysis of color M-mode Doppler images. RESULTS: In both animals and humans, LV-EDV and LV-EDP decreased significantly from baseline to IVC occlusion (both p < 0.001). Peak early filling (E) velocity decreased in animals from 56 ± 21 to 42 ± 17 cm/s (p < 0.001) without change in v(p) (from 35 ± 15 to 35 ± 16, p = 0.99). Results were similar in humans (from 69 ± 15 to 53 ± 22 cm/s, p < 0.001, and 37 ± 12 to 34 ± 16, p = 0.30). In both species, there was a strong correlation between LV relaxation (tau) and v(p) (r = 0.78, p < 0.001, r = 0.86, p < 0.001). CONCLUSIONS: Our results indicate that color M-mode Doppler v(p) is not affected by preload alterations and confirms that LV relaxation is its main physiologic determinant in both animals during varying lusitropic conditions and in humans with heart disease.

Original languageEnglish (US)
Pages (from-to)201-208
Number of pages8
JournalJournal of the American College of Cardiology
Volume35
Issue number1
DOIs
StatePublished - Jan 2000
Externally publishedYes

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Color
Venae Cavae
Cardiopulmonary Bypass
Stroke Volume
Heart Diseases
Dogs
Blood Pressure

ASJC Scopus subject areas

  • Nursing(all)

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Color M-mode Doppler flow propagation velocity is a preload insensitive index of left ventricular relaxation : Animal and human validation. / Garcia, Mario J.; Smedira, Nicholas G.; Greenberg, Neil L.; Main, Michael; Firstenberg, Michael S.; Odabashian, Jill; Thomas, James D.

In: Journal of the American College of Cardiology, Vol. 35, No. 1, 01.2000, p. 201-208.

Research output: Contribution to journalArticle

Garcia, Mario J. ; Smedira, Nicholas G. ; Greenberg, Neil L. ; Main, Michael ; Firstenberg, Michael S. ; Odabashian, Jill ; Thomas, James D. / Color M-mode Doppler flow propagation velocity is a preload insensitive index of left ventricular relaxation : Animal and human validation. In: Journal of the American College of Cardiology. 2000 ; Vol. 35, No. 1. pp. 201-208.
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abstract = "OBJECTIVES: To determine the effect of preload in color M-mode Doppler flow propagation velocity (v(p)). BACKGROUND: The interpretation of Doppler filling patterns is limited by confounding effects of left ventricular (LV) relaxation and preload. Color M-mode v(p) has been proposed as a new index of LV relaxation. METHODS: We studied four dogs before and during inferior caval (IVC) occlusion at five different inotropic stages and 14 patients before and during partial cardiopulmonary bypass. Left ventricular (LV) end-diastolic volumes (LV-EDV), the time constant of isovolumic relaxation (tau), left atrial (LA) pre-A and LV end-diastolic pressures (LV-EDP) were measured. Peak velocity during early filling (E) and v(p) were extracted by digital analysis of color M-mode Doppler images. RESULTS: In both animals and humans, LV-EDV and LV-EDP decreased significantly from baseline to IVC occlusion (both p < 0.001). Peak early filling (E) velocity decreased in animals from 56 ± 21 to 42 ± 17 cm/s (p < 0.001) without change in v(p) (from 35 ± 15 to 35 ± 16, p = 0.99). Results were similar in humans (from 69 ± 15 to 53 ± 22 cm/s, p < 0.001, and 37 ± 12 to 34 ± 16, p = 0.30). In both species, there was a strong correlation between LV relaxation (tau) and v(p) (r = 0.78, p < 0.001, r = 0.86, p < 0.001). CONCLUSIONS: Our results indicate that color M-mode Doppler v(p) is not affected by preload alterations and confirms that LV relaxation is its main physiologic determinant in both animals during varying lusitropic conditions and in humans with heart disease.",
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T1 - Color M-mode Doppler flow propagation velocity is a preload insensitive index of left ventricular relaxation

T2 - Animal and human validation

AU - Garcia, Mario J.

AU - Smedira, Nicholas G.

AU - Greenberg, Neil L.

AU - Main, Michael

AU - Firstenberg, Michael S.

AU - Odabashian, Jill

AU - Thomas, James D.

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N2 - OBJECTIVES: To determine the effect of preload in color M-mode Doppler flow propagation velocity (v(p)). BACKGROUND: The interpretation of Doppler filling patterns is limited by confounding effects of left ventricular (LV) relaxation and preload. Color M-mode v(p) has been proposed as a new index of LV relaxation. METHODS: We studied four dogs before and during inferior caval (IVC) occlusion at five different inotropic stages and 14 patients before and during partial cardiopulmonary bypass. Left ventricular (LV) end-diastolic volumes (LV-EDV), the time constant of isovolumic relaxation (tau), left atrial (LA) pre-A and LV end-diastolic pressures (LV-EDP) were measured. Peak velocity during early filling (E) and v(p) were extracted by digital analysis of color M-mode Doppler images. RESULTS: In both animals and humans, LV-EDV and LV-EDP decreased significantly from baseline to IVC occlusion (both p < 0.001). Peak early filling (E) velocity decreased in animals from 56 ± 21 to 42 ± 17 cm/s (p < 0.001) without change in v(p) (from 35 ± 15 to 35 ± 16, p = 0.99). Results were similar in humans (from 69 ± 15 to 53 ± 22 cm/s, p < 0.001, and 37 ± 12 to 34 ± 16, p = 0.30). In both species, there was a strong correlation between LV relaxation (tau) and v(p) (r = 0.78, p < 0.001, r = 0.86, p < 0.001). CONCLUSIONS: Our results indicate that color M-mode Doppler v(p) is not affected by preload alterations and confirms that LV relaxation is its main physiologic determinant in both animals during varying lusitropic conditions and in humans with heart disease.

AB - OBJECTIVES: To determine the effect of preload in color M-mode Doppler flow propagation velocity (v(p)). BACKGROUND: The interpretation of Doppler filling patterns is limited by confounding effects of left ventricular (LV) relaxation and preload. Color M-mode v(p) has been proposed as a new index of LV relaxation. METHODS: We studied four dogs before and during inferior caval (IVC) occlusion at five different inotropic stages and 14 patients before and during partial cardiopulmonary bypass. Left ventricular (LV) end-diastolic volumes (LV-EDV), the time constant of isovolumic relaxation (tau), left atrial (LA) pre-A and LV end-diastolic pressures (LV-EDP) were measured. Peak velocity during early filling (E) and v(p) were extracted by digital analysis of color M-mode Doppler images. RESULTS: In both animals and humans, LV-EDV and LV-EDP decreased significantly from baseline to IVC occlusion (both p < 0.001). Peak early filling (E) velocity decreased in animals from 56 ± 21 to 42 ± 17 cm/s (p < 0.001) without change in v(p) (from 35 ± 15 to 35 ± 16, p = 0.99). Results were similar in humans (from 69 ± 15 to 53 ± 22 cm/s, p < 0.001, and 37 ± 12 to 34 ± 16, p = 0.30). In both species, there was a strong correlation between LV relaxation (tau) and v(p) (r = 0.78, p < 0.001, r = 0.86, p < 0.001). CONCLUSIONS: Our results indicate that color M-mode Doppler v(p) is not affected by preload alterations and confirms that LV relaxation is its main physiologic determinant in both animals during varying lusitropic conditions and in humans with heart disease.

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