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Colour M‐mode velocity propagation: a glance at intra‐ventricular pressure gradients and early diastolic ventricular performance
Author(s) -
De Boeck Bart W.L.,
Oh Jae K.,
Vandervoort Pieter M.,
Vierendeels Jan A.,
Aa Ronald P.L.M.,
Cramer MaartenJan M.
Publication year - 2005
Publication title -
european journal of heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.149
H-Index - 133
eISSN - 1879-0844
pISSN - 1388-9842
DOI - 10.1016/j.ejheart.2004.03.010
Subject(s) - preload , cardiology , medicine , diastole , ventricular pressure , isovolumic relaxation time , pressure gradient , blood pressure , doppler echocardiography , hemodynamics , mechanics , physics
The physiology of early‐diastolic filling comprises ventricular performance and fluid dynamical principles. Elastic recoil and myocardial relaxation rate determine left ventricular early diastolic performance. The integrity of left ventricular synchrony and geometry is essential to maintain the effect of their timely action on early diastolic left ventricular filling. These factors not only are prime determinants of left ventricular pressure decay during isovolumic relaxation and immediately after mitral valve opening; they also instigate the generation of a sufficient intra‐ventricular pressure gradient, which enhances efficient early diastolic left ventricular filling. Accurate assessment of diastolic (dys)function by non‐invasive techniques has important therapeutic and prognostic implications but remains a challenge to the cardiologist. The evaluation of left ventricular relaxation by the standard Doppler echocardiographic parameters is hindered by their preload dependency. The colour M‐mode velocity propagation of early diastolic inflow (Vp) correlates with intra‐ventricular pressure gradients and is a largely preload independent index of ventricular diastolic performance. In this article, the physiologic background, utility and limitations of this promising new tool for the study of early diastolic filling are reviewed.