Transmitral flow velocity-contour variation after premature ventricular contractions: a novel test of the load-independent index of diastolic filling

Ultrasound Med Biol. 2008 Dec;34(12):1901-8. doi: 10.1016/j.ultrasmedbio.2008.05.002. Epub 2008 Aug 9.

Abstract

The new echocardiography-based, load-independent index of diastolic filling (LIIDF) M was assessed using load-/shape-varying E-waves after premature ventricular contractions (PVCs). Twenty-six PVCs in 15 subjects from a preexisting simultaneous echocardiography-catheterization database were selected. Perturbed load-state beats, defined as the first two post-PVC E-waves, and steady-state E-waves, were subjected to conventional and model-based analysis. M, a dimensionless index, defined by the slope of the peak driving-force vs. peak (filling-opposing) resistive-force regression, was determined from steady-state E-waves alone, and from load-perturbed E-waves combined with a matched number of subsequent beats. Despite high degrees of E-wave shape variation, M derived from load-varying, perturbed beats and M derived from steady-state beats alone were indistinguishable. Because the peak driving-force vs. peak resistive-force relation determining M remains highly linear in the extended E-wave shape and load variation regime observed, we conclude that M is a robust LIIDF.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Blood Flow Velocity
  • Diastole
  • Echocardiography, Doppler / methods
  • Hemodynamics
  • Humans
  • Middle Aged
  • Mitral Valve / diagnostic imaging
  • Mitral Valve / physiopathology*
  • Models, Cardiovascular
  • Ventricular Function, Left
  • Ventricular Premature Complexes / diagnostic imaging
  • Ventricular Premature Complexes / physiopathology*