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(Circulation. 2005;112:1684-1686.)
© 2005 American Heart Association, Inc.

Editorial

Intraventricular Pressure Differences

A New Window Into Cardiac Function

James D. Thomas, MD; Zoran B. Popovi, MD

From the Cardiovascular Imaging Center, Department of Cardiovascular Medicine, The Cleveland Clinic Foundation, Cleveland, Ohio.

Correspondence to James D. Thomas, MD, Department of Cardiology, Desk F-15, The Cleveland Clinic Foundation, 9500 Euclid Ave, Cleveland, OH 44195. E-mail thomasj@ccf.org

Key Words: Editorials • contractility • echocardiography • physiology • systole

An extract of the first 250 words of the full text is provided, because this article has no abstract.

Like all fluids, blood tends to flow from areas of high pressure to low pressure. This seemingly trite observation hides a great deal of sophisticated pathophysiology that we are only beginning to exploit diagnostically and potentially therapeutically. In this issue of Circulation, Yotti and colleagues have exploited a new noninvasive technique to measure the small pressure differences generated within the normal left ventricular outflow tract in systole, demonstrating the utility of such measurements in quantifying ventricular systolic function.¹ Because the fluid dynamics concepts behind these methods remain obscure to many cardiologists, it is worth reviewing the theoretical underpinnings in the hope that they will be more widely applied on the basis of articles like those of Yotti et al and others.

See p 1771

Cardiologists have become comfortable with the use of the Gorlin equation in the cardiac catheterization laboratory and the simplified Bernoulli equation in the echocardiography laboratory to characterize the severity of valvular stenosis. Both equations are based on the principle of conservation of energy, relating the pressure drop (potential energy) across the valve to the rise in velocity (kinetic energy) as blood rushes through it. Several special circumstances combine to make these simple equations particularly applicable to flow through a restrictive orifice, including lack of a significant friction factor (viscosity) and a lack of pressure recovery as the blood rushes out of the abrupt obstruction. One of the most important simplifications is the absence of a significant "inertial" component to flow through a restrictive orifice. That . . . [Full Text of this Article]

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Doppler-Derived Ejection Intraventricular Pressure Gradients Provide a Reliable Assessment of Left Ventricular Systolic Chamber Function

Raquel Yotti, Javier Bermejo, M. Mar Desco, J. Carlos Antoranz, José Luis Rojo-Álvarez, Cristina Cortina, Carmen Allué, Hugo Rodríguez-Abella, Mar Moreno, and Miguel A. García-Fernández
Circulation 2005 112: 1771-1779. [Abstract] [Full Text]

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