Kinematic modeling-based left ventricular diastatic (passive) chamber stiffness determination with in-vivo validation

Sina Mossahebi, Sándor J. Kovács

Research output: Contribution to journalArticlepeer-review

13 Scopus citations

Abstract

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).

Original languageEnglish
Pages (from-to)987-995
Number of pages9
JournalAnnals of biomedical engineering
Volume40
Issue number5
DOIs
StatePublished - May 2012

Keywords

  • Diastatic stiffness
  • Diastolic function
  • Echocardiography
  • Hemodynamics
  • Kinematic modeling
  • Left ventricle

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