Estimation of left ventricular operating stiffness from Doppler early filling deceleration time in humans

Mario J. Garcia, Michael S. Firstenberg, Neil L. Greenberg, Nicholas Smedira, Leonardo Rodriguez, David Prior, James D. Thomas

Research output: Contribution to journalArticle

73 Scopus citations

Abstract

Shortened early transmitral deceleration times (EDT) have been qualitatively associated with increased filling pressure and reduced survival in patients with cardiac disease and increased left ventricular operating stiffness (KLV). An equation relating KLV quantitatively to EDT has previously been described in a canine model but not in humans. During several varying hemodynamic conditions, we studied 18 patients undergoing open-heart surgery. Transesophageal echocardiographic two-dimensional volumes and Doppler flows were combined with high-fidelity left atrial (LA) and left ventricular (LV) pressures to determine KLV. From digitized Doppler recordings, EDT was measured and compared against changes in LV and LA diastolic volumes and pressures. EDT (180 ± 39 ms) was inversely associated with LV end-diastolic pressures (r = -0.56, P = 0.004) and net atrioventricular stiffness (r = -0.55, P = 0.006) but had its strongest association with KLV (r = -0.81, P < 0.001). KLV was predicted assuming a nonrestrictive orifice (Knonrest) from EDT as Knonrest = (0.07/EDT)2 with KLV = 1.01 Knonrest -0.02; r = 0.86, P < 0.001, ΔK (Knonrest - KLV) = 0.02 ± 0.06 mmHg/ml. In adults with cardiac disease, EDT provides an accurate estimate of LV operating stiffness and supports its application as a practical noninvasive index in the evaluation of diastolic function.

Original languageEnglish (US)
Pages (from-to)H554-H561
JournalAmerican Journal of Physiology - Heart and Circulatory Physiology
Volume280
Issue number2 49-2
DOIs
StatePublished - Feb 2001
Externally publishedYes

Keywords

  • Diastole
  • Echocardiography
  • Myocardial stiffness

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

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