Abstract 15082: Diastolic Suction Kinetic Energy in Heart Failure: Relation with Left Ventricular Geometry, Untwist, and Flow Mechanics
Objective: Diastolic suction is a major determinant of early left ventricular (LV) filling. LV untwisting has been reported to provide a temporal link between ventricular relaxation and suction. The purpose of the present study was to assess suction kinetic energy and to investigate the relationship between LV systolic function, untwisting, geometry and flow mechanics in heart failure (HF) patients.
Methods: Thirty subjects with elevated LV filling pressure with pseudonormalized Doppler filling pattern (HF-group; LVEF 54±19%) and 36 normal subjects (normal-group; LVEF 68±8%) were enrolled. Suction was defined as the apical flow directing to the apex during the period from soon after the ejection to before mitral inflow. Flow kinetic energy was quantified as the sum of the products of blood mass and velocity vector using Echo-Dynamography. Magnitude and time to peak suction kinetic energy were measured.
Results: Suction was recognized 17 patients (57%) in HF-group and 36 subjects (100%) in normal-group. HF-group showed significantly smaller suction kinetic energy (13210 vs. 25542 g/sec, P<0.01) and delayed timing (511±109 vs. 448±52 msec, P<0.01) than normal-group. HF-group with suction showed smaller LV end systolic volume (ESV) (P<0.05), more ellipsoidal geometry (P<0.05), and greater untwisting rate (P<0.01) than those in HF patients without suction. In ROC analysis with cut off value of 51 deg/sec of untwisting rate showed 90% sensitivity and 89% specificity for the presence of suction in HF-group.
Conclusion: The magnitude and timing of the suction flow derived from Echo-Dynamography may allow quantitative assessment of suction flow, which correlates to LV systolic function, geometry, and untwisting mechanics.
- © 2011 by American Heart Association, Inc.