Effects of changes in atrioventricular gradient and contractility on left ventricular filling in human diastolic cardiac dysfunction

Daniel J. Lenihan, Myron C. Gerson, Gerald W. Dorn, Brian D. Hoit, Richard A. Walsh, Sherri Rosser, Chris Huth

Research output: Contribution to journalArticlepeer-review

9 Scopus citations

Abstract

The factors responsible for abnormalities in diastolic filling indexes as assessed by noninvasive testing in human beings have been extensively studied but are not completely understood. We therefore investigated left ventricular diastolic filling indexes by radionuclide angiography during right atrial pacing simultaneously with assessment of a directly measured left atrioventricular gradient and a time constant of isovolumic relaxation in 11 patients with hypertension and diastolic dysfunction. Loading conditions were altered with nitroprusside and phenylephrine, and contractility was improved by dobutamine infusion. The maximum left atrioventricular gradient at constant heart rates was determined by loading conditions and was not significantly affected by increases in contractility or an improvement in isovolumic relaxation rate. The peak filling rate according to radionuclide angiography was highly dependent on the atrioventricular gradient and was not affected by enhancement of the isovolumic relaxation rate.

Original languageEnglish
Pages (from-to)1179-1188
Number of pages10
JournalAmerican heart journal
Volume132
Issue number6
DOIs
StatePublished - 1996

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