Abstract 15495: Elevated Left Ventricular End Diastolic Pressure Reduces Intra Left Ventricular Pressure Gradient During Atrial Contraction
Background: Vector Flow Mapping (VFM, Hitachi-Aloka) was recently developed to obtain intra-left ventricular pressure gradient (IVPG) from the data set of blood flow velocity vectors obtained in the left ventricle (LV). Our hypothesis was that a stiffer LV deteriorated the IVPG during atrial contraction (AC). We investigated this hypothesis using the VFM.
Methods: Study subjects were 47 patients in sinus rhythm underwent cardiac catheterization and echocardiographic examination on the same day (averaged age was 69 years, 20% of them were female, the range of LV ejection fraction 28.8% - 83.6%). Conventional color Doppler images were acquired in the apical 3-chamber view. The analyses were performed using an echo image analyzer (DAS-RS1, Hitachi-Aloka). A sampling line was set from the apex to the level of mitral annulus; then the maximal value of IVPG with respect to distance during AC (IVPG-AC) was computed as shown in Figure. LV end-diastolic pressure (LVEDP) and LV volumes were obtained in cardiac catheterization. LV end-diastolic volume was indexed to the body surface area (LVEDVI).
Results: The value of IVPG-AC was -0.19 ± 0.06 mm Hg/cm. IVPG-AC had significant positive correlations with both LVEDP and LVEDVI (r=0.76, p<0.001 and r=0.67, p<0.001, respectively). Even in the patients with preserved LV ejection fraction (>50%), IVPG-AC also had a significant positive correlation with LVEDP (r=0.70, p<0.001).
Conclusions: The elevated LVEDP or increased LV stiffness disturbs the blood flowing from the left atrium toward the LV apex during AC. Using the VFM, LV late diastolic function can be assessed noninvasively.
Author Disclosures: K. Wakami: None. M. Ishida: None. T. Banno: None. K. Muto: None. J. Yamamoto: None. S. Kikuchi: None. K. Yamamoto: None. T. Goto: None. H. Fukuta: None. N. Ohte: None.
- © 2016 by American Heart Association, Inc.