Effects of myocardial ischaemia on left ventricular untwist and filling pressure

Abstract

Patients with abnormal filling pressure response have an impaired LV untwisting rate during isovolumic relaxation. This phenomenon supports the role of impaired LV suction as the mediator of the effect of myocardial ischaemia during DSE on filling pressure response to stress.

The Role of Tissue Doppler Imaging in Predicting Left Ventricular Filling Pressures in Patients Undergoing Cardiac Surgery: An Intraoperative Study

“…37 Finally, the concomitant use of inotropes and increase in catecholamines causing acute hemodynamic variations have been shown to affect Doppler indices in patients with CAD. 38,39 Our study is not without limitations. As we do not routinely insert PAC in our cardiac surgical population at our center, our study is limited by the small number of study subjects with both PAC and TEE measurements during surgery.…”

“…This discrepancy exists during the period before and after cardiac surgery as observed using speckle Doppler tracking in CABG patients and needs to be further investigated as it relates to LVFP intraoperatively . Finally, the concomitant use of inotropes and increase in catecholamines causing acute hemodynamic variations have been shown to affect Doppler indices in patients with CAD …”

Left ventricular biomechanics in professional football players

“…Also others reported augmented untwisting acutely during exercise in endurance athletes and following long‐term structured exercise program . In contrast, delayed untwisting has been shown in ischemia, valvular heart disease, and hypertrophic obstructive cardiomyopathy (HOCM) . In addition, septal reduction in HOCM largely normalized the timing of untwisting and improved exercise capacity .…”

Imaging techniques and coronary artery disease –a review

“…As ischaemia disturbs diastolic relaxation of the left ventricle before systolic wall motion abnormalities appear, some researchers have suggested that evaluation of stress-induced diastolic dysfunction of the LV (mitral inflow patterns) or individual segments (deformation analysis) could be used as a surrogate marker of early ischaemia. 31,32 Stress methods for echocardiographic analysis exercise stress Exercise is the stress method most widely used to induce ischaemia. In patients with adequate exercise capacity, exercise stress echocardiography (ESE) allows measurement of various physiological variables in addition to echocardiographic imaging.…”