Determinants of diastolic myocardial tissue Doppler velocities: Influences of relaxation and preload

M. S. Firstenberg; N. L. Greenberg; M. L. Main; J. K. Drinko; J. A. Odabashian; J. D. Thomas; M. J. Garcia

doi:10.1152/jappl.2001.90.1.299

Determinants of diastolic myocardial tissue Doppler velocities: Influences of relaxation and preload

M. S. Firstenberg, N. L. Greenberg, M. L. Main, J. K. Drinko, J. A. Odabashian, J. D. Thomas, M. J. Garcia

Medicine

Research output: Contribution to journal › Article › peer-review

135 Scopus citations

Abstract

Myocardial tissue Doppler echocardiography (TDE) has been proposed as a tool for the assessment of diastolic function. Controversy exists regarding whether TDE measurements are influenced by preload. In this study, left ventricular volume and high-fidelity pressures were obtained in eight closed-chest dogs during intermittent caval occlusion. The time constant of isovolumic ventricular relaxation (τ) was altered with varying doses of dobutamine and esmolol. Peak early diastolic myocardial (E_m) and transmitral (E) velocities were measured before and after preload reduction. The relative effects of changes in preload and relaxation were determined for E_m and compared with their effects on E. The following results were observed: caval occlusion significantly decreased E (ΔE = 16.4 ± 3.3 cm/s, 36.6 ± 13.7%, P < 0.01) and E_m (ΔE_m = 1.3 ± 0.4 cm/s, 32.5 ± 26.1%,P < 0.01) under baseline conditions. However, preload reduction was similar for E under all lusitropic conditions (P = not significant), but these effects on E_m decreased with worsening relaxation. At τ < 50 ms, changes in E_m with preload reduction were significantly greater (ΔE_m = 2.8 ± 0.6 cm/s) than at τ= 50-65 ms (ΔE_m = 1.2 ± 0.2 cm/s) and at τ>65 ms (ΔE_m = 0.5 ± 0.1 cm/s, P < 0.05). We concluded that TDE E_m is preload dependent. However, this effect decreases with worsening relaxation.

Original language	English (US)
Pages (from-to)	299-307
Number of pages	9
Journal	Journal of applied physiology
Volume	90
Issue number	1
DOIs	https://doi.org/10.1152/jappl.2001.90.1.299
State	Published - 2001

Keywords

Diastolic function
Tissue Doppler echocardiography
Ventricular relaxation

ASJC Scopus subject areas

Physiology
Physiology (medical)

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@article{16c9b3bc409648219df8ebc26d8a37ce,

title = "Determinants of diastolic myocardial tissue Doppler velocities: Influences of relaxation and preload",

abstract = "Myocardial tissue Doppler echocardiography (TDE) has been proposed as a tool for the assessment of diastolic function. Controversy exists regarding whether TDE measurements are influenced by preload. In this study, left ventricular volume and high-fidelity pressures were obtained in eight closed-chest dogs during intermittent caval occlusion. The time constant of isovolumic ventricular relaxation (τ) was altered with varying doses of dobutamine and esmolol. Peak early diastolic myocardial (Em) and transmitral (E) velocities were measured before and after preload reduction. The relative effects of changes in preload and relaxation were determined for Em and compared with their effects on E. The following results were observed: caval occlusion significantly decreased E (ΔE = 16.4 ± 3.3 cm/s, 36.6 ± 13.7%, P < 0.01) and Em (ΔEm = 1.3 ± 0.4 cm/s, 32.5 ± 26.1%,P < 0.01) under baseline conditions. However, preload reduction was similar for E under all lusitropic conditions (P = not significant), but these effects on Em decreased with worsening relaxation. At τ < 50 ms, changes in Em with preload reduction were significantly greater (ΔEm = 2.8 ± 0.6 cm/s) than at τ= 50-65 ms (ΔEm = 1.2 ± 0.2 cm/s) and at τ>65 ms (ΔEm = 0.5 ± 0.1 cm/s, P < 0.05). We concluded that TDE Em is preload dependent. However, this effect decreases with worsening relaxation.",

keywords = "Diastolic function, Tissue Doppler echocardiography, Ventricular relaxation",

author = "Firstenberg, {M. S.} and Greenberg, {N. L.} and Main, {M. L.} and Drinko, {J. K.} and Odabashian, {J. A.} and Thomas, {J. D.} and Garcia, {M. J.}",

year = "2001",

doi = "10.1152/jappl.2001.90.1.299",

language = "English (US)",

volume = "90",

pages = "299--307",

journal = "Journal of Applied Physiology",

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TY - JOUR

T1 - Determinants of diastolic myocardial tissue Doppler velocities

T2 - Influences of relaxation and preload

AU - Firstenberg, M. S.

AU - Greenberg, N. L.

AU - Main, M. L.

AU - Drinko, J. K.

AU - Odabashian, J. A.

AU - Thomas, J. D.

AU - Garcia, M. J.

PY - 2001

Y1 - 2001

N2 - Myocardial tissue Doppler echocardiography (TDE) has been proposed as a tool for the assessment of diastolic function. Controversy exists regarding whether TDE measurements are influenced by preload. In this study, left ventricular volume and high-fidelity pressures were obtained in eight closed-chest dogs during intermittent caval occlusion. The time constant of isovolumic ventricular relaxation (τ) was altered with varying doses of dobutamine and esmolol. Peak early diastolic myocardial (Em) and transmitral (E) velocities were measured before and after preload reduction. The relative effects of changes in preload and relaxation were determined for Em and compared with their effects on E. The following results were observed: caval occlusion significantly decreased E (ΔE = 16.4 ± 3.3 cm/s, 36.6 ± 13.7%, P < 0.01) and Em (ΔEm = 1.3 ± 0.4 cm/s, 32.5 ± 26.1%,P < 0.01) under baseline conditions. However, preload reduction was similar for E under all lusitropic conditions (P = not significant), but these effects on Em decreased with worsening relaxation. At τ < 50 ms, changes in Em with preload reduction were significantly greater (ΔEm = 2.8 ± 0.6 cm/s) than at τ= 50-65 ms (ΔEm = 1.2 ± 0.2 cm/s) and at τ>65 ms (ΔEm = 0.5 ± 0.1 cm/s, P < 0.05). We concluded that TDE Em is preload dependent. However, this effect decreases with worsening relaxation.

AB - Myocardial tissue Doppler echocardiography (TDE) has been proposed as a tool for the assessment of diastolic function. Controversy exists regarding whether TDE measurements are influenced by preload. In this study, left ventricular volume and high-fidelity pressures were obtained in eight closed-chest dogs during intermittent caval occlusion. The time constant of isovolumic ventricular relaxation (τ) was altered with varying doses of dobutamine and esmolol. Peak early diastolic myocardial (Em) and transmitral (E) velocities were measured before and after preload reduction. The relative effects of changes in preload and relaxation were determined for Em and compared with their effects on E. The following results were observed: caval occlusion significantly decreased E (ΔE = 16.4 ± 3.3 cm/s, 36.6 ± 13.7%, P < 0.01) and Em (ΔEm = 1.3 ± 0.4 cm/s, 32.5 ± 26.1%,P < 0.01) under baseline conditions. However, preload reduction was similar for E under all lusitropic conditions (P = not significant), but these effects on Em decreased with worsening relaxation. At τ < 50 ms, changes in Em with preload reduction were significantly greater (ΔEm = 2.8 ± 0.6 cm/s) than at τ= 50-65 ms (ΔEm = 1.2 ± 0.2 cm/s) and at τ>65 ms (ΔEm = 0.5 ± 0.1 cm/s, P < 0.05). We concluded that TDE Em is preload dependent. However, this effect decreases with worsening relaxation.

KW - Diastolic function

KW - Tissue Doppler echocardiography

KW - Ventricular relaxation

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JO - Journal of Applied Physiology

JF - Journal of Applied Physiology

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