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Alteration of left ventricular diastolic function during coronary angioplasty-induced ischemia: a color M-mode Doppler study.

Abstract：

OBJECTIVES:The aim of this study was to assess the effects of ischemia on diastolic function by analyzing flow propagation velocity with color M-mode Doppler echocardigraphy. BACKGROUND:Color M-mode Doppler echocardiography has been proposed as a method of assessing left ventricular filling. METHODS:Color M-mode Doppler echocardiography and measurement of hemodynamic data were performed simultaneously at baseline and during angioplasty-induced ischemia. Tau was compared with flow propagation velocity. Late diastolic indexes, left ventricular pressure and flow cessation time were also investigated. RESULTS:During ischemia, left ventricular relaxation rate (tau) increased, whereas flow propagation velocity decreased, from (mean +/- SD) 46.8 +/- 10 ms to 72.6 +/- 18.3 ms and from 59.8 +/- 15.8 cm/s to 30 +/- 8 cm/s, respectively (all p < 0.0001). The maximal slowing of flow propagation velocity was observed 20 to 30 s after the beginning of the inflation, coexisting with a notch on the ascending limb of the negative rate of rise of the left ventricular pressure (dP/dt) curve. Flow propagation velocity was correlated with tau both at baseline (r = 0.53, p < 0.05) and during inflation (r = 0.53, p < 0.03). Left ventricular end-diastolic pressure increased during ischemia from 13.5 +/- 8 mm Hg at baseline to 27.5 +/- 7 mm Hg, while a premature cessation of the entering flow occurred -13.8 +/- 23 ms before the next Q wave onset, compared with 4.5 +/- 19.6 ms after the Q wave onset at baseline (all p < 0.0001). CONCLUSIONS:The analysis of flow propagation velocity showed that early filling is highly dependent on left ventricular relaxation rate, particularly through the phenomenon of asynchrony. During ischemia, the premature cessation of late filling is associated with increased diastolic pressures.

journal_name

J Am Coll Cardiol

journal_title

Journal of the American College of Cardiology

authors

Duval-Moulin AM,Dupouy P,Brun P,Zhuang F,Pelle G,Perez Y,Teiger E,Castaigne A,Gueret P,Dubois-Randé JL

doi

10.1016/s0735-1097(97)00052-1

subject

Has Abstract

pub_date

1997-05-01 00:00:00

pages

1246-55

issue

eissn

0735-1097

issn

1558-3597

pii

S0735109797000521

journal_volume

pub_type

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Alteration of left ventricular diastolic function during coronary angioplasty-induced ischemia: a color M-mode Doppler study.