Estimation of diastolic intraventricular pressure gradients by Doppler M-mode echocardiography

• Published in: American journal of physiology. Heart and circulatory physiology 2001-06, Vol.280 (6), p.H2507-H2515
• Main Authors: Greenberg, Neil L, Vandervoort, Pieter M, Firstenberg, Michael S, Garcia, Mario J, Thomas, James D
• Format: Article
• Language: English
• Subjects: Animals; Blood Pressure - drug effects; Blood Pressure - physiology; Cardiotonic Agents - administration & dosage; Computer Simulation; Diastole - physiology; Dogs; Echocardiography - methods; Isoproterenol - administration & dosage; Life Sciences (General); Linear Models; Models, Cardiovascular; Reproducibility of Results; Space life sciences; Ventricular Function, Left - drug effects; Ventricular Function, Left - physiology
• ISSN: 0363-6135; 1522-1539
• DOI: 10.1152/ajpheart.2001.280.6.h2507

1  Cardiovascular Imaging Center, Department of Cardiology, The Cleveland Clinic Foundation, Cleveland, Ohio 44195; and 2  Heart Center Limburg, Genk 3600, Belgium Previous studies have shown that small intraventricular pressure gradients (IVPG) are important for efficient filling of the left ventricle (LV) and as a sensitive marker for ischemia. Unfortunately, there has previously been no way of measuring these noninvasively, severely limiting their research and clinical utility. Color Doppler M-mode (CMM) echocardiography provides a spatiotemporal velocity distribution along the inflow tract throughout diastole, which we hypothesized would allow direct estimation of IVPG by using the Euler equation. Digital CMM images, obtained simultaneously with intracardiac pressure waveforms in six dogs, were processed by numerical differentiation for the Euler equation, then integrated to estimate IVPG and the total (left atrial to left ventricular apex) pressure drop. CMM-derived estimates agreed well with invasive measurements (IVPG: y  = 0.87 x  + 0.22,  r  = 0.96,  P