A Novel Noninvasive Method to Assess Left Ventricular −dP/dt Using Diastolic Blood Pressure and Isovolumic Relaxation Time

Background: Left ventricular D oppler‐derived −dP/dt determined from the continuous‐wave D oppler spectrum of the mitral regurgitation ( MR ) jet has been shown to be a valuable marker of diastolic function, but requires the presence of MR for its assessment. We sought to determine if a novel method of determining −dP/dt using the diastolic blood pressure and isovolumic relaxation time ( DBP ‐ IVRT method) correlates with D oppler‐derived −dP/dt using the MR method ( D oppler‐ MR method). Methods: Thirty‐three patients with less than severe MR were enrolled. −dP/dt was determined using the D oppler‐ MR method from the continuous‐wave D oppler spectrum of the MR jet (32 mmHg/time from 3 to 1 m/sec). −dP/dt was also determined using the DBP ‐ IVRT method using the following equation: −dP/dt = ( DBP  −  LVEDP )/ IVRT , where left ventricular end‐diastolic pressure ( LVEDP ) was estimated based on tissue D oppler and mitral inflow patterns. Results: Twenty‐five patients had adequate Doppler waveforms for analysis. The average amount of MR was mild‐to‐moderate severity. The mean −dP/dt was 680 ± 201 mmHg by the D oppler‐ MR method and 681 ± 237 mmHg by the DBP ‐ IVRT method. There was a significant correlation between the 2 methods of determining −dP/dt (Pearson r = 0.574, P = 0.003). The Bland–Altman plot revealed almost no bias between the 2 methods; the difference in −dP/dt between the 2 techniques was noted to be greater for patients with higher −dP/dt, however. Conclusion: Diastolic blood pressure and isovolumic relaxation time may be used to noninvasively assess diastolic function in patients who do not have MR , especially in those with reduced diastolic function.