Journal of Applied Physiology
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J Appl Physiol 91: 154-162, 2001;
8750-7587/01 $5.00
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Vol. 91, Issue 1, 154-162, July 2001

Chamber properties from transmitral flow: prediction of average and passive left ventricular diastolic stiffness

Jennifer B. Lisauskas, Jasvindar Singh, Andrew W. Bowman, and Sándor J. Kovács

Cardiovascular Biophysics Laboratory, Washington University School of Medicine, St. Louis, Missouri 63110

A chamber stiffness (KLV)-transmitral flow (E-wave) deceleration time relation has been invasively validated in dogs with the use of average stiffness [(Delta P/Delta V)avg]. KLV is equivalent to kE, the (E-wave) stiffness of the parameterized diastolic filling model. Prediction and validation of 1) (Delta P/Delta V)avg in terms of kE, 2) early rapid-filling stiffness [(Delta P/Delta V)E] in terms of kE, and 3) passive (postdiastasis) chamber stiffness [(Delta P/Delta V)PD] from A waves in terms of the stiffness parameter for the Doppler A wave (kA) have not been achieved. Simultaneous micromanometric left ventricular (LV) pressure (LVP) and transmitral flow from 131 subjects were analyzed. (Delta P)avg and (Delta V)avg utilized the minimum LVP-LV end-diastolic pressure interval. (Delta P/Delta V)E utilized Delta P and Delta V from minimum LVP to E-wave termination. (Delta P/Delta V)PD utilized atrial systolic Delta P and Delta V. E- and A-wave analysis generated kE and kA. For all subjects, noninvasive-invasive relations yielded the following equations: kE = 1,401 · (Delta P/Delta V)avg + 59.2 (r = 0.84) and kE = 229.0 · (Delta P/Delta V)E + 112 (r = 0.80). For subjects with diastasis (n = 113), kA = 1,640 · (Delta P/Delta V)PD - 8.40 (r = 0.89). As predicted, kA showed excellent correlation with (Delta P/Delta V)PD; kE correlated highly with (Delta P/Delta V)avg. In vivo validation of average, early, and passive chamber stiffness facilitates quantitative, noninvasive diastolic function assessment from transmitral flow.

diastole; echocardiography; hemodynamics; ventricles; mathematical modeling


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