JACC
HOME SUBSCRIPTIONS CURRENT ISSUE PAST ISSUES CARDIOSOURCE SEARCH HELP FEEDBACK
 QUICK SEARCH:   [advanced]


     


J Am Coll Cardiol, 2003; 41:1590-1597, doi:10.1016/S0735-1097(03)00260-2
© 2003 by the American College of Cardiology Foundation
This Article
Right arrow Figures Only
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Hasegawa, H.
Right arrow Articles by Cheng, C.-P.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Hasegawa, H.
Right arrow Articles by Cheng, C.-P.

CLINICAL RESEARCH

Diastolic mitral annular velocityduring the development of heart failure

Hiroshi Hasegawa, MD, PhD*, William C. Little, MD*,*, Michiya Ohno, MD, PhD*, Steffen Brucks, MD*, Atsushi Morimoto, MD, PhD*, Heng-Jie Cheng, MD, PhD* and Che-Ping Cheng, MD, PhD*

* Cardiology Section, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA

Manuscript received November 4, 2002; revised manuscript received January 14, 2003, accepted January 24, 2003.

* Reprint requests and correspondence: Dr. William C. Little, Cardiology Section, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, North Carolina 27157-1045, USA.
wlittle{at}wfubmc.edu

OBJECTIVES: We sought to investigate the mechanism of reduced diastolic mitral annular velocity with diastolic dysfunction, despite elevated left atrial (LA) pressure.

BACKGROUND: The peak rate of left ventricular (LV) early diastolic filling (E) and velocity of the mitral annulus due to long-axis lengthening (EM) are reduced in mild diastolic dysfunction. With more severe dysfunction, E increases in response to increased LA pressures. In contrast, EM decreases, despite increased LA pressure.

METHODS: We studied eight dogs instrumented to measure LA pressure, LV pressure, and internal dimensions during the progressive development of heart failure (HF) produced by rapid pacing.

RESULTS: Early diastolic filling decreased after four days of pacing from 114 ± 32 to 88 ± 22 ml/s (p < 0.05), but with more severe HF, it progressively increased to 155 ± 32 ml/s (p < 0.05). In contrast, EM progressively decreased from 44 ± 12 mm/s during the control period to 24 ± 8 mm/s after four weeks (p < 0.05). Although EM was related to the time constant of LV relaxation (tau) (R2 = 0.85), E was not. The latter occurred coincident with termination of the early diastolic LA to LV pressure gradient during all conditions. In contrast, with increasing HF, EM was progressively delayed after LA to LV pressure crossover by 37 ± 12 ms (p < 0.05). The time from E to EM was related to tau (R2 = 0.97).

CONCLUSIONS: With slowed relaxation during the development of HF, EM is reduced and delayed so that it occurs after early, rapid filling. Thus, with slowed relaxation, EM does not respond to the early diastolic LA to LV pressure gradient, because it occurs when LV pressure is greater than or equal to LA pressure.

Abbreviations and Acronyms
  DAP = anteroposterior dimension
  DLA = long-axis dimension
  DSL = septolateral dimension
  dV/dt = time derivative of left ventricular volume
  E = peak early diastolic left ventricular filling
  EM = peak velocity of mitral annulus away from apex during early diastole
  HF = heart failure
  LA = left atrial/atrium
  LV = left ventricle/ventricular
  tau = time constant




This article has been cited by other articles:


Home page
CirculationHome page
S. Masutani, W. C. Little, H. Hasegawa, H.-J. Cheng, and C.-P. Cheng
Response to Letter Regarding Article, "Restrictive Left Ventricular Filling Pattern Does Not Result From Increased Left Atrial Pressure Alone"
Circulation, September 23, 2008; 118(13): e506 - e506.
[Full Text] [PDF]


Home page
CirculationHome page
J. Wang, D. S. Khoury, Y. Yue, G. Torre-Amione, and S. F. Nagueh
Response to Letter Regarding Article, "Left Ventricular Untwisting Rate by Speckle Tracking Echocardiography"
Circulation, May 13, 2008; 117(19): e337 - e337.
[Full Text] [PDF]


Home page
HeartHome page
G W K Yip, M Wang, T Wang, S Chan, J W H Fung, L Yeung, T Yip, S-T Lau, C-P Lau, M-O Tang, et al.
The Hong Kong diastolic heart failure study: a randomised controlled trial of diuretics, irbesartan and ramipril on quality of life, exercise capacity, left ventricular global and regional function in heart failure with a normal ejection fraction
Heart, May 1, 2008; 94(5): 573 - 580.
[Abstract] [Full Text] [PDF]


Home page
CirculationHome page
S. Masutani, W. C. Little, H. Hasegawa, H.-J. Cheng, and C.-P. Cheng
Restrictive Left Ventricular Filling Pattern Does Not Result From Increased Left Atrial Pressure Alone
Circulation, March 25, 2008; 117(12): 1550 - 1554.
[Abstract] [Full Text] [PDF]


Home page
Eur Heart JHome page
L. Hatle
How to diagnose diastolic heart failure a consensus statement
Eur. Heart J., October 2, 2007; 28(20): 2421 - 2423.
[Full Text] [PDF]


Home page
CirculationHome page
W. H. Gaasch and W. C. Little
Assessment of Left Ventricular Diastolic Function and Recognition of Diastolic Heart Failure
Circulation, August 7, 2007; 116(6): 591 - 593.
[Full Text] [PDF]


Home page
J Am Coll CardiolHome page
C.-M. Yu, J. E. Sanderson, T. H. Marwick, and J. K. Oh
Tissue Doppler Imaging: A New Prognosticator for Cardiovascular Diseases
J. Am. Coll. Cardiol., May 15, 2007; 49(19): 1903 - 1914.
[Abstract] [Full Text] [PDF]


Home page
CirculationHome page
J. Wang, D. S. Khoury, V. Thohan, G. Torre-Amione, and S. F. Nagueh
Global Diastolic Strain Rate for the Assessment of Left Ventricular Relaxation and Filling Pressures
Circulation, March 20, 2007; 115(11): 1376 - 1383.
[Abstract] [Full Text] [PDF]


Home page
J. Appl. Physiol.Home page
L. Shmuylovich and S. J. Kovacs
Load-independent index of diastolic filling: model-based derivation with in vivo validation in control and diastolic dysfunction subjects
J Appl Physiol, July 1, 2006; 101(1): 92 - 101.
[Abstract] [Full Text] [PDF]


Home page
Proc. Natl. Acad. Sci. USAHome page
M. Gharib, E. Rambod, A. Kheradvar, D. J. Sahn, and J. O. Dabiri
Optimal vortex formation as an index of cardiac health
PNAS, April 18, 2006; 103(16): 6305 - 6308.
[Abstract] [Full Text] [PDF]


Home page
J Am Coll CardiolHome page
J. K. Oh, L. Hatle, A. J. Tajik, and W. C. Little
Diastolic Heart Failure Can Be Diagnosed by Comprehensive Two-Dimensional and Doppler Echocardiography
J. Am. Coll. Cardiol., February 7, 2006; 47(3): 500 - 506.
[Abstract] [Full Text] [PDF]


Home page
J. Appl. Physiol.Home page
Q. Ruan, L. Rao, K. J. Middleton, D. S. Khoury, and S. F. Nagueh
Assessment of left ventricular diastolic function by early diastolic mitral annulus peak acceleration rate: experimental studies and clinical application
J Appl Physiol, February 1, 2006; 100(2): 679 - 684.
[Abstract] [Full Text] [PDF]


Home page
CirculationHome page
W. C. Little
Diastolic Dysfunction Beyond Distensibility: Adverse Effects of Ventricular Dilatation
Circulation, November 8, 2005; 112(19): 2888 - 2890.
[Full Text] [PDF]


Home page
ChestHome page
J.-W. Ha, J.-R. Cho, J.-M. Kim, J.-A. Ahn, E.-Y. Choi, S.-M. Kang, S.-J. Rim, and N. Chung
Tissue Doppler-Derived Indices Predict Exercise Capacity in Patients With Apical Hypertrophic Cardiomyopathy
Chest, November 1, 2005; 128(5): 3428 - 3433.
[Abstract] [Full Text] [PDF]


Home page
CirculationHome page
J. K. Oh
Echocardiography as a Noninvasive Swan-Ganz Catheter
Circulation, June 21, 2005; 111(24): 3192 - 3194.
[Full Text] [PDF]


Home page
CirculationHome page
A. Diwan, M. McCulloch, G. M. Lawrie, M. J. Reardon, and S. F. Nagueh
Doppler Estimation of Left Ventricular Filling Pressures in Patients With Mitral Valve Disease
Circulation, June 21, 2005; 111(24): 3281 - 3289.
[Abstract] [Full Text] [PDF]


Home page
J Am Coll CardiolHome page
A. E. Weyman
The year in echocardiography
J. Am. Coll. Cardiol., February 1, 2005; 45(3): 448 - 455.
[Full Text] [PDF]


Home page
Br J AnaesthHome page
M. Filipovic, J. Wang, I. Michaux, P. Hunziker, K. Skarvan, and M. D. Seeberger
Effects of halothane, sevoflurane and propofol on left ventricular diastolic function in humans during spontaneous and mechanical ventilation
Br. J. Anaesth., February 1, 2005; 94(2): 186 - 192.
[Abstract] [Full Text] [PDF]


Home page
J Am Coll CardiolHome page
D.-W. Sohn, Y.-J. Kim, Y.-B. Park, and Y.-S. Choi
Clinical validity of measuring time difference between onset of mitral inflow and onset of early diastolic mitral annulus velocity in the evaluation of left ventricular diastolic function
J. Am. Coll. Cardiol., June 2, 2004; 43(11): 2097 - 2101.
[Abstract] [Full Text] [PDF]


Home page
J Am Coll CardiolHome page
M. Henein and P. O'Callaghan
"From bedside to bench"
J. Am. Coll. Cardiol., March 3, 2004; 43(5): 928 - 928.
[Full Text] [PDF]


Home page
J Am Coll CardiolHome page
W. C. Little
Reply
J. Am. Coll. Cardiol., March 3, 2004; 43(5): 928 - 928.
[Full Text] [PDF]


Home page
J Am Coll CardiolHome page
A. E. Weyman
The year in echocardiography
J. Am. Coll. Cardiol., January 7, 2004; 43(1): 140 - 148.
[Full Text] [PDF]


Home page
J Am Coll CardiolHome page
C. Rivas-Gotz, D. S. Khoury, M. Manolios, L. Rao, H. A. Kopelen, and S. F. Nagueh
Time interval between onset of mitral inflow and onset of early diastolic velocity by tissue Doppler: a novel index of left ventricular relaxation: Experimental studies and clinical application
J. Am. Coll. Cardiol., October 15, 2003; 42(8): 1463 - 1470.
[Abstract] [Full Text] [PDF]


Home page
J Am Coll CardiolHome page
J. K. Oh and J. Tajik
The return of cardiac time intervals: The Phoenix is rising
J. Am. Coll. Cardiol., October 15, 2003; 42(8): 1471 - 1474.
[Full Text] [PDF]




HOME SUBSCRIPTIONS CURRENT ISSUE PAST ISSUES CARDIOSOURCE SEARCH HELP FEEDBACK
Copyright © 2003 by the American College of Cardiology Foundation.