Author + information
- Received April 20, 1995
- Revision received August 28, 1995
- Accepted August 31, 1995
- Published online February 1, 1996.
- Hiroya Takatsuji, MD*,a,
- Taisei Mikami, MDa,
- Kazushi Urasawa, MDa,
- Jun-Ichi Teranishi, MDa,
- Hisao Onozuka, MDa,
- Chika Takagi, MDa,
- Yasuhiro Makita, MDa,
- Hisashi Matsuo, MDa,
- Hideo Kusuoka, MD,FACC* and
- Akira Kitabatake, MD,PhD,FACCa
- ↵*Address for correspondence: Dr. Hiroya Takatsuji, Department of Cardiovascular Medicine, Hokkaido University School of Medicine, Kita 15, Nishi 7, Kita-ku, Sapporo 060, Japan.
Objectives. To evaluate left ventricular diastolic function and differentiate the pseudonormalized transmitral flow pattern from the normal pattern, the propagation of left ventricular early filling flow was assessed quantitatively using color M-mode Doppler echocardiography.
Background. Because the propagation of left ventricular early filling flow is disturbed in the left ventricle with impaired relaxation, quantification of such alterations should provide useful indexes for the evaluation of left ventricular diastolic function.
Methods. Study subjects were classified into three groups according to the ratio of early to late transmitral flow velocity (E/A ratio) and left ventricular ejection fraction: 29 subjects with an ejection fraction ≥60% (control group); 34 with an ejection fraction <60% and E/A ratio <1 (group I); and 25 with ejection fraction <60% and E/A ratio ≥1 (group II). The propagation of peak early filling flow was visualized by charging the first aliasing limit of the color Doppler signals. The rate of propagation of peak early filling flow velocity was defined as the distance/time ratio between two sampling points: the point of the maximal velocity around the mitral orifice and the point in the mid-left ventricle at which the velocity decreased to 70% of its initial value. High fidelity manometer-tipped measurement was performed in 40 randomly selected subjects.
Results. The rate of propagation decreased in groups I and II compared with that in the control group (33.8 ± 13.8 [mean ± SD] and 30.0 ± 8.6 vs. 74.3 ± 17.4 cm/s, p < 0.001, respectively) and correlated inversely with the time constant of left ventricular isovolumetric relaxation and the minimal first derivative of left ventricular pressure (peak negative dP/dt) (r = 0.82 and r = 0.72, respectively).
Conclusions. Spatial and temporal analysis of filling flow propagation by color M-mode Doppler echocardiography was free of pseudonormalization and correlated well with the invasive variables of left ventricular relaxation.
This study was funded in part by Grant-in-Aid 06557041 for Scientific Research from the Ministry of Education, Science and Culture of Japan, Tokyo.
- Received April 20, 1995.
- Revision received August 28, 1995.
- Accepted August 31, 1995.