BACKGROUND: Ejection intraventricular pressure gradients are caused by the systolic force developed by the left ventricle (LV). By postprocessing color Doppler M-mode (CDMM) images, we can measure noninvasively the ejection intraventricular pressure difference (EIVPD) between the LV apex and the outflow tract. This study was designed to assess the value of Doppler-derived EIVPDs as noninvasive indices of systolic chamber function. METHODS AND RESULTS: CDMM images and pressure-volume (conductance) signals were simultaneously acquired in 9 minipigs undergoing pharmacological interventions and acute ischemia. Inertial, convective, and total EIVPD curves were calculated from CDMM recordings. Peak EIVPD closely correlated with indices of systolic function based on the pressure-volume relationship: peak elastance (within-animal R=0.98; between-animals R=0.99), preload recruitable stroke work (within-animal R=0.81; between-animals R=0.86), and peak of the first derivative of pressure corrected for end-diastolic volume (within-animal R=0.88; between-animals R=0.91). The correlation of peak inertial EIVPD with these indices was also high (all R>0.75). Load dependence of EIVPDs was studied in another 5 animals in which consecutive beats obtained during load manipulation were analyzed. During caval occlusion (40% EDV reduction), dP/dtmax, ejection fraction, and stroke volume significantly changed, whereas peak EIVPD remained constant. Aortic occlusion (40% peak LV pressure increase) significantly modified dP/dtmax, ejection fraction, and stroke volume; a nearly significant trend toward decreasing peak EIVPD was observed (P=0.06), whereas inertial EIVPD was unchanged (P=0.6). EIVPD beat-to-beat and interobserver variabilities were 2+/-12% and 5+/-11%, respectively. CONCLUSIONS: Doppler-derived EIVPDs provide quantitative, reproducible, and relatively load-independent indices of global systolic chamber function that correlate closely with currently available reference methods.
BACKGROUND: Ejection intraventricular pressure gradients are caused by the systolic force developed by the left ventricle (LV). By postprocessing color Doppler M-mode (CDMM) images, we can measure noninvasively the ejection intraventricular pressure difference (EIVPD) between the LV apex and the outflow tract. This study was designed to assess the value of Doppler-derived EIVPDs as noninvasive indices of systolic chamber function. METHODS AND RESULTS: CDMM images and pressure-volume (conductance) signals were simultaneously acquired in 9 minipigs undergoing pharmacological interventions and acute ischemia. Inertial, convective, and total EIVPD curves were calculated from CDMM recordings. Peak EIVPD closely correlated with indices of systolic function based on the pressure-volume relationship: peak elastance (within-animal R=0.98; between-animals R=0.99), preload recruitable stroke work (within-animal R=0.81; between-animals R=0.86), and peak of the first derivative of pressure corrected for end-diastolic volume (within-animal R=0.88; between-animals R=0.91). The correlation of peak inertial EIVPD with these indices was also high (all R>0.75). Load dependence of EIVPDs was studied in another 5 animals in which consecutive beats obtained during load manipulation were analyzed. During caval occlusion (40% EDV reduction), dP/dtmax, ejection fraction, and stroke volume significantly changed, whereas peak EIVPD remained constant. Aortic occlusion (40% peak LV pressure increase) significantly modified dP/dtmax, ejection fraction, and stroke volume; a nearly significant trend toward decreasing peak EIVPD was observed (P=0.06), whereas inertial EIVPD was unchanged (P=0.6). EIVPD beat-to-beat and interobserver variabilities were 2+/-12% and 5+/-11%, respectively. CONCLUSIONS: Doppler-derived EIVPDs provide quantitative, reproducible, and relatively load-independent indices of global systolic chamber function that correlate closely with currently available reference methods.
Authors: Candelas Pérez Del Villar; Javier Bermejo; Daniel Rodríguez-Pérez; Pablo Martínez-Legazpi; Yolanda Benito; J Carlos Antoranz; M Mar Desco; Juan E Ortuño; Alicia Barrio; Teresa Mombiela; Raquel Yotti; Maria J Ledesma-Carbayo; Juan C Del Álamo; Francisco Fernández-Avilés Journal: Cardiovasc Res Date: 2015-02-17 Impact factor: 10.787
Authors: Francisco J Londono-Hoyos; Abigail Swillens; Joris Van Cauwenberge; Brett Meyers; Maheswara Reddy Koppula; Pavlos Vlachos; Julio A Chirinos; Patrick Segers Journal: Med Biol Eng Comput Date: 2017-08-16 Impact factor: 2.602
Authors: Snigdha Jain; Francisco J Londono; Patrick Segers; Thierry C Gillebert; Marc De Buyzere; Julio A Chirinos Journal: Curr Heart Fail Rep Date: 2016-02
Authors: Francisco Londono-Hoyos; Patrick Segers; Zeba Hashmath; Garrett Oldland; Maheshwara Reddy Koppula; Khuzaima Javaid; Rachana Miller; Rushikkumar Bhuva; Izzah Vasim; Ali Tariq; Walter Witschey; Scott Akers; Julio Alonso Chirinos Journal: Open Heart Date: 2019-10-09