A new approach for evaluation of left ventricular diastolic function: Spatial and temporal analysis of left ventricular filling flow propagation by color M-mode doppler echocardiography

Abstract

Spatial and temporal analysis of filling flow propagation by color M-mode Doppler echocardiography was free of pseudonormalization and correlated well with the invasive variables of left ventricular relaxation.

Diastolic Filling and Pressure Imaging: Taking Advantage of the Information in a Colour M-mode Doppler Image

“…Also, in a univariate analysis, several investigators found a significant correlation between left atrial pressure, left ventricular minimal pressure or left ventricular enddiastolic pressure on one hand and v p on the other hand [47][48][49]52,58,59,61] . In contrast, in multivariate analysis, most studies were not able to demonstrate a significant [47] , in a multivariate model, both the relaxation constant and the difference between left ventricular pressure at mitral valve opening and minimal left ventricular pressure remained simultaneously significant variables for determining v p .…”

“…Takatsuji et al [52] determined the v p using the baseline shift, displaying the flow velocities higher than the aliasing velocities in blue within the red filling flow signals. First the point of maximal velocity around the mitral orifice in early diastole was located.…”

“…None the less, the automated algorithm provides more observer-independent determinations; minor noise in an image can strongly influence the determination of v p , yielding large beat-to-beat variabilities. The strict procedure as proposed by Takatsuji et al [52] has, in case of manual execution, the advantage of filtering out variability. However, analogous to the method of Stugaard, this method finally calculates v p using only two selected pixels, yielding potential sensitivity to noise in an automated procedure, yielding high beat-to-beat variabilities.…”

“…Studies (Table 3) in both animals and humans during coronary angioplasty-induced ischaemia [49,51,58] , during intra-coronary dobutamine infusion [47] , before and during cardiopulmonary bypass [59] , in a mixed patient population [52] and in patients with hypertrophic cardiomyopathy [60] describe a univariate correlation of the constant of isovolumic relaxation (tau) with v p as obtained from the colour M-mode Doppler images. In both animals and humans, Garcia and co-workers [59] found that left ventricular relaxation is a major determinant of v p , best described using a power function tau=592·21 v p 0·6838 (r= 0·78, P<0·001).…”

Echocardiographic evaluation of diastolic heart failure

“…During myocardial ischemia or HF, there is slowing of the LV base to apical flow propagation 60 , 61 . A Vp > 50 cm/s is considered normal 62 while a value < 45 cm/s in patients > 30 years is consistent with DD 63 .…”