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Estimation of diastolic intraventricular pressure gradients by Doppler M-mode echocardiographyPrevious studies have shown that small intraventricular pressure gradients (IVPG) are important for efficient filling of the left ventricle (LV) and as a sensitive marker for ischemia. Unfortunately, there has previously been no way of measuring these noninvasively, severely limiting their research and clinical utility. Color Doppler M-mode (CMM) echocardiography provides a spatiotemporal velocity distribution along the inflow tract throughout diastole, which we hypothesized would allow direct estimation of IVPG by using the Euler equation. Digital CMM images, obtained simultaneously with intracardiac pressure waveforms in six dogs, were processed by numerical differentiation for the Euler equation, then integrated to estimate IVPG and the total (left atrial to left ventricular apex) pressure drop. CMM-derived estimates agreed well with invasive measurements (IVPG: y = 0.87x + 0.22, r = 0.96, P < 0.001, standard error of the estimate = 0.35 mmHg). Quantitative processing of CMM data allows accurate estimation of IVPG and tracking of changes induced by beta-adrenergic stimulation. This novel approach provides unique information on LV filling dynamics in an entirely noninvasive way that has previously not been available for assessment of diastolic filling and function.
Document ID
20040112441
Acquisition Source
Legacy CDMS
Document Type
Reprint (Version printed in journal)
Authors
Greenberg, N. L.
(The Cleveland Clinic Foundation Cleveland, Ohio 44195, United States)
Vandervoort, P. M.
Firstenberg, M. S.
Garcia, M. J.
Thomas, J. D.
Date Acquired
August 21, 2013
Publication Date
June 1, 2001
Publication Information
Publication: American journal of physiology. Heart and circulatory physiology
Volume: 280
Issue: 6
ISSN: 0363-6135
Subject Category
Life Sciences (General)
Funding Number(s)
CONTRACT_GRANT: RO1-HL-56688-01A1
Distribution Limits
Public
Copyright
Other
Keywords
Non-NASA Center
NASA Discipline Cardiopulmonary

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