TY - JOUR
T1 - Kinematic modeling-based left ventricular diastatic (passive) chamber stiffness determination with in-vivo validation
AU - Mossahebi, Sina
AU - Kovács, Sándor J.
N1 - Funding Information:
This study was supported in part by the Alan A. and Edith L. Wolff Charitable Trust, St. Louis, and the Barnes-Jewish Hospital Foundation, St. Louis. The authors thank sonographer Peggy Brown for expert echocardiographic data acquisition, and the staff of the BJH Cardiovascular Procedure Center’s Cardiac Catheterization Laboratory for their assistance.
PY - 2012/5
Y1 - 2012/5
N2 - The slope of the diastatic pressure-volume relationship (D-PVR) defines passive left ventricular (LV) stiffness K: Although K is a relative measure, cardiac catheterization, which is an absolute measurement method, is used to obtain the former. Echocardiography, including transmitral flow velocity (Doppler E-wave) analysis, is the preferred quantitative diastolic function (DF) assessment method. However, E-wave analysis can provide only relative, rather than absolute pressure information. We hypothesized that physiologic mechanism-based modeling of E-waves allows derivation of the D-PVR E-wave whose slope, K E-wave, provides E-wave-derived diastatic, passive chamber stiffness. Our kinematic model of filling and Bernoulli's equation were used to derive expressions for diastatic pressure and volume on a beat-by-beat basis, thereby generating D-PVR E-wave, and K E-wave. For validation, simultaneous (conductance catheter) P-V and echocardiographic E-wave data from 30 subjects (444 total cardiac cycles) having normal LV ejection fraction (LVEF) were analyzed. For each subject (15 beats average) model-predicted K E-wave was compared to experimentally measured K CATH via linear regression yielding as follows: K E-wave = αK CATH + b (R 2 = 0:92), where, α = 0.995 and b = 0.02. We conclude that echocardiographically determined diastatic passive chamber stiffness, K E-wave, provides an excellent estimate of simultaneous, gold standard (P-V)-defined diastatic stiffness, K CATH. Hence, in chambers at diastasis, passive LV stiffness can be accurately determined by means of suitable analysis of Doppler E-waves (transmitral flow).
AB - The slope of the diastatic pressure-volume relationship (D-PVR) defines passive left ventricular (LV) stiffness K: Although K is a relative measure, cardiac catheterization, which is an absolute measurement method, is used to obtain the former. Echocardiography, including transmitral flow velocity (Doppler E-wave) analysis, is the preferred quantitative diastolic function (DF) assessment method. However, E-wave analysis can provide only relative, rather than absolute pressure information. We hypothesized that physiologic mechanism-based modeling of E-waves allows derivation of the D-PVR E-wave whose slope, K E-wave, provides E-wave-derived diastatic, passive chamber stiffness. Our kinematic model of filling and Bernoulli's equation were used to derive expressions for diastatic pressure and volume on a beat-by-beat basis, thereby generating D-PVR E-wave, and K E-wave. For validation, simultaneous (conductance catheter) P-V and echocardiographic E-wave data from 30 subjects (444 total cardiac cycles) having normal LV ejection fraction (LVEF) were analyzed. For each subject (15 beats average) model-predicted K E-wave was compared to experimentally measured K CATH via linear regression yielding as follows: K E-wave = αK CATH + b (R 2 = 0:92), where, α = 0.995 and b = 0.02. We conclude that echocardiographically determined diastatic passive chamber stiffness, K E-wave, provides an excellent estimate of simultaneous, gold standard (P-V)-defined diastatic stiffness, K CATH. Hence, in chambers at diastasis, passive LV stiffness can be accurately determined by means of suitable analysis of Doppler E-waves (transmitral flow).
KW - Diastatic stiffness
KW - Diastolic function
KW - Echocardiography
KW - Hemodynamics
KW - Kinematic modeling
KW - Left ventricle
UR - http://www.scopus.com/inward/record.url?scp=84862013524&partnerID=8YFLogxK
U2 - 10.1007/s10439-011-0458-3
DO - 10.1007/s10439-011-0458-3
M3 - Article
C2 - 22065203
AN - SCOPUS:84862013524
VL - 40
SP - 987
EP - 995
JO - Annals of Biomedical Engineering
JF - Annals of Biomedical Engineering
SN - 0090-6964
IS - 5
ER -