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Novel echocardiographic method to assess left ventricular chamber stiffness and elevated end-diastolic pressure based on time-velocity integral measurements of pulmonary venous and transmitral flows

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Please use this identifier to cite or link to this item:http://hdl.handle.net/2115/76080

Title: Novel echocardiographic method to assess left ventricular chamber stiffness and elevated end-diastolic pressure based on time-velocity integral measurements of pulmonary venous and transmitral flows
Authors: Okada, Kazunori Browse this author
Kaga, Sanae Browse this author
Abiko, Rika Browse this author
Murayama, Michito Browse this author
Hioka, Takuma Browse this author
Nakabachi, Masahiro Browse this author
Yokoyama, Shinobu Browse this author
Nishino, Hisao Browse this author
Ichikawa, Ayako Browse this author
Abe, Ayumu Browse this author
Nishida, Mutsumi Browse this author →KAKEN DB
Asakawa, Naoya Browse this author
Tsujinaga, Shingo Browse this author
Hayashi, Taichi Browse this author
Iwano, Hiroyuki Browse this author
Yamada, Satoshi Browse this author →KAKEN DB
Masauzi, Nobuo Browse this author
Mikami, Taisei Browse this author →KAKEN DB
Keywords: left ventricular chamber stiffness
left ventricular end-diastolic pressure
pulmonary venous flow
heart failure
Issue Date: 8-Nov-2017
Publisher: Oxford University Press
Journal Title: European heart journal cardiovascular Imaging
Volume: 19
Issue: 11
Start Page: 1260
End Page: 1267
Publisher DOI: 10.1093/ehjci/jex305
PMID: 29228231
Abstract: Aims The detection of increased left ventricular (LV) chamber stiffness may play an important role in assessing cardiac patients with potential but not overt heart failure. A non-invasive method to estimate it is not established. We investigated whether the echocardiographic backward/forward flow volume ratio from the left atrium (LA) during atrial contraction reflects the LV chamber stiffness. Methods and results We studied 62 patients who underwent cardiac catheterization and measured their left ventricular end-diastolic pressure (LVEDP) and pressure increase during atrial contraction (Delta Pa) from the LV pressure waveform. Using the echocardiographic biplane method of disks, we measured the LV volume change during atrial contraction indexed to the body surface area (Delta Va), and Delta Pa/Delta Va was calculated as a standard for the LV operating chamber stiffness. Using pulsed Doppler echocardiography, we measured the time-velocity integral (TVI) of the backward pulmonary venous (PV) flow during atrial contraction (I-PVA) and the ratio of I-PVA to the PV flow TVI throughout a cardiac cycle (F-PVA). We also measured the TVI of the atrial systolic forward transmitral flow (I-A) and the ratio of the I-A to the transmitral TVI during a cardiac cycle (F-A) and calculated I-PVA/I-A and F-PVA/F-A. IPVA/IA and F-PVA/F-A were well correlated with Delta Pa/Delta Va (r = 0.79 and r = 0.81) and LVEDP (r = 0.73 and r = 0.77). The areas under the ROC curve to discriminate LVEDP > 18mmHg were 0.90 for I-PVA/I-A and 0.93 for F-PVA/F-A. Conclusion The F-PVA/F-A, the backward/forward flow volume ratio from the LA during atrial contraction, is useful for noninvasive assessments of LV chamber stiffness and elevated LVEDP.
Rights: This is a pre-copyedited, author-produced version of an article accepted for publication in European heart journal cardiovascular imaging following peer review. The version of record Eur J Echocardiogr (2018) 19(11): 1260-1267 is available online at: https://academic.oup.com/ehjcimaging/article/19/11/1260/4710343
Type: article (author version)
URI: http://hdl.handle.net/2115/76080
Appears in Collections:保健科学院・保健科学研究院 (Graduate School of Health Sciences / Faculty of Health Sciences) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 岡田 一範

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