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Increase in the Late Diastolic Filling Force Is Associated With Impaired Transmitral Flow Efficiency in Acute Moderate Elevation of Left Ventricular Afterload

2009; Wiley; Volume: 28; Issue: 2 Linguagem: Inglês

10.7863/jum.2009.28.2.175

1550-9613

Panupong Jiamsripong, Anna M. Calleja, Mohsen Alharthi, Eun Joo Cho, Eileen M. McMahon, Jeffrey J. Heys, Michele Milano, Partho P. Sengupta, Bijoy K. Khandheria, Marek Bělohlávek,

Pulmonary Hypertension Research and Treatments

Journal of Ultrasound in MedicineVolume 28, Issue 2 p. 175-182 Article Increase in the Late Diastolic Filling Force Is Associated With Impaired Transmitral Flow Efficiency in Acute Moderate Elevation of Left Ventricular Afterload Panupong Jiamsripong MD, Panupong Jiamsripong MD Translational Ultrasound Research Laboratory, Division of Cardiovascular Diseases, Mayo Clinic Arizona, Scottsdale, Arizona USASearch for more papers by this authorAnna M. Calleja MD, Anna M. Calleja MD Translational Ultrasound Research Laboratory, Division of Cardiovascular Diseases, Mayo Clinic Arizona, Scottsdale, Arizona USASearch for more papers by this authorMohsen S. Alharthi MD, Mohsen S. Alharthi MD Translational Ultrasound Research Laboratory, Division of Cardiovascular Diseases, Mayo Clinic Arizona, Scottsdale, Arizona USASearch for more papers by this authorEun Joo Cho MD, PhD, Eun Joo Cho MD, PhD Translational Ultrasound Research Laboratory, Division of Cardiovascular Diseases, Mayo Clinic Arizona, Scottsdale, Arizona USASearch for more papers by this authorEileen M. McMahon PhD, Eileen M. McMahon PhD Translational Ultrasound Research Laboratory, Division of Cardiovascular Diseases, Mayo Clinic Arizona, Scottsdale, Arizona USASearch for more papers by this authorJeffrey J. Heys PhD, Jeffrey J. Heys PhD Ira A. Fulton School of Engineering, Arizona State University, Tempe, Arizona USASearch for more papers by this authorMichele Milano PhD, Michele Milano PhD Ira A. Fulton School of Engineering, Arizona State University, Tempe, Arizona USASearch for more papers by this authorPartho P. Sengupta MD, Partho P. Sengupta MD Translational Ultrasound Research Laboratory, Division of Cardiovascular Diseases, Mayo Clinic Arizona, Scottsdale, Arizona USASearch for more papers by this authorBijoy K. Khandheria MD, Bijoy K. Khandheria MD Translational Ultrasound Research Laboratory, Division of Cardiovascular Diseases, Mayo Clinic Arizona, Scottsdale, Arizona USASearch for more papers by this authorMarek Belohlavek MD, PhD, Corresponding Author Marek Belohlavek MD, PhD [email protected] Translational Ultrasound Research Laboratory, Division of Cardiovascular Diseases, Mayo Clinic Arizona, Scottsdale, Arizona USAAddress correspondence to Marek Belohlavek, MD, PhD, Mayo Clinic, 13400 E Shea Blvd, Johnson Research Building, 3-361, Scottsdale, AZ 85259 USA.Search for more papers by this author Panupong Jiamsripong MD, Panupong Jiamsripong MD Translational Ultrasound Research Laboratory, Division of Cardiovascular Diseases, Mayo Clinic Arizona, Scottsdale, Arizona USASearch for more papers by this authorAnna M. Calleja MD, Anna M. Calleja MD Translational Ultrasound Research Laboratory, Division of Cardiovascular Diseases, Mayo Clinic Arizona, Scottsdale, Arizona USASearch for more papers by this authorMohsen S. Alharthi MD, Mohsen S. Alharthi MD Translational Ultrasound Research Laboratory, Division of Cardiovascular Diseases, Mayo Clinic Arizona, Scottsdale, Arizona USASearch for more papers by this authorEun Joo Cho MD, PhD, Eun Joo Cho MD, PhD Translational Ultrasound Research Laboratory, Division of Cardiovascular Diseases, Mayo Clinic Arizona, Scottsdale, Arizona USASearch for more papers by this authorEileen M. McMahon PhD, Eileen M. McMahon PhD Translational Ultrasound Research Laboratory, Division of Cardiovascular Diseases, Mayo Clinic Arizona, Scottsdale, Arizona USASearch for more papers by this authorJeffrey J. Heys PhD, Jeffrey J. Heys PhD Ira A. Fulton School of Engineering, Arizona State University, Tempe, Arizona USASearch for more papers by this authorMichele Milano PhD, Michele Milano PhD Ira A. Fulton School of Engineering, Arizona State University, Tempe, Arizona USASearch for more papers by this authorPartho P. Sengupta MD, Partho P. Sengupta MD Translational Ultrasound Research Laboratory, Division of Cardiovascular Diseases, Mayo Clinic Arizona, Scottsdale, Arizona USASearch for more papers by this authorBijoy K. Khandheria MD, Bijoy K. Khandheria MD Translational Ultrasound Research Laboratory, Division of Cardiovascular Diseases, Mayo Clinic Arizona, Scottsdale, Arizona USASearch for more papers by this authorMarek Belohlavek MD, PhD, Corresponding Author Marek Belohlavek MD, PhD [email protected] Translational Ultrasound Research Laboratory, Division of Cardiovascular Diseases, Mayo Clinic Arizona, Scottsdale, Arizona USAAddress correspondence to Marek Belohlavek, MD, PhD, Mayo Clinic, 13400 E Shea Blvd, Johnson Research Building, 3-361, Scottsdale, AZ 85259 USA.Search for more papers by this author First published: 01 February 2009 https://doi.org/10.7863/jum.2009.28.2.175Citations: 9Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Abstract Objective. Analysis of intraventricular flow force and efficiency is a novel concept of quantitatively assessing left ventricular (LV) hemodynamic performance. We have parametrically characterized diastolic filling flow by early inflow force, late inflow force, and total inflow force and by vortex formation time (VFT), a fundamental parameter of fluid transport efficiency. The purpose of this study was to determine what changes in inflow forces characterize a decrease in diastolic blood transport efficiency in acute moderate elevation of LV afterload. Methods. In 8 open-chested pigs, the flow force and VFT parameters were calculated from conventional and flow Doppler echocardiographic measurements at baseline and during a brief (3-minute) moderate elevation of afterload induced by increasing the systolic blood pressure to 130% of the baseline value. Results. Systolic LV function decreased significantly during elevated afterload. Early inflow force did not significantly change, whereas late inflow force increased from 5,822.09 ± 1,656.5 (mean ± SD) to 13,948.25 ± 9,773.96 dyne (P = .049), and total inflow force increased from 13,783.35 ± 4,816.58 to 21,836.67 ± 8,635.33 dyne (P = .031). Vortex formation time decreased from 4.09 ± 0.29 to 2.79 ± 1.1 (P = .0068), confirming suboptimal flow transport efficiency. Conclusions. Even a brief moderate increase of LV afterload causes a significant increase in late diastolic filling force and impairs transmitral flow efficiency. References 1Ohno M, Cheng CP, Little WC. Mechanism of altered patterns of left ventricular filling during the development of congestive heart failure. Circulation 1994; 89: 2241–2250. 2Vasan RS, Larson MG, Benjamin EJ, Evans JC, Reiss CK, Levy D. Congestive heart failure in subjects with normal versus reduced left ventricular ejection fraction: prevalence and mortality in a population-based cohort. 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