TY - GEN
T1 - Quantitative assessment of left ventricular diastolic function via Longitudinal and Transverse flow impedances
AU - Ghosh, Erina
AU - Kovacs, Sandor J.
PY - 2012
Y1 - 2012
N2 - Flow impedance has been used to characterize the physical properties of the vascular system by assessing its phasic flow response to pulsatile pressure input in terms of resistance as a function of frequency. Impedance has also been used to characterize global diastolic left ventricular (LV) chamber properties. In early diastole the LV is a mechanical suction pump and accommodates filling by simultaneously expanding in two principal spatial directions: longitudinal (base-to-apex, long-axis) and transverse (radial, short-axis). Total (characteristic) impedance ZC is the product of longitudinal (Z L) and transverse (ZT) impedance as ZC 2=ZLZT where the two impedances reflect the relative spatial propensity for volume accommodation. In this work we compute ZL and ZT for the LV in early diastole. We analyze simultaneously recorded dual pressure-transducer and transthoracic echocardiographic flow data obtained during cardiac catheterization in 11 subjects. We found that ZL was 2 orders of magnitude smaller than ZT in all subjects, providing the first hemodynamic evidence, in concordance with cine-MRI imaging data that longitudinal volume accommodation is indeed, nature's preferred spatial filling mechanism. We also investigated the effect of impaired diastolic function on directional impedances and found that ZL increased (becomes worse) while ZT decreased (becomes better) indicating that as diastolic function becomes impaired radial filling compensates for decreased longitudinal volume accommodation to preserve stroke volume. These results provide mechanistic insight and show that normal diastolic function defines a properly impedance matched state and that diastolic dysfunction is equivalent to a state of impedance mismatch.
AB - Flow impedance has been used to characterize the physical properties of the vascular system by assessing its phasic flow response to pulsatile pressure input in terms of resistance as a function of frequency. Impedance has also been used to characterize global diastolic left ventricular (LV) chamber properties. In early diastole the LV is a mechanical suction pump and accommodates filling by simultaneously expanding in two principal spatial directions: longitudinal (base-to-apex, long-axis) and transverse (radial, short-axis). Total (characteristic) impedance ZC is the product of longitudinal (Z L) and transverse (ZT) impedance as ZC 2=ZLZT where the two impedances reflect the relative spatial propensity for volume accommodation. In this work we compute ZL and ZT for the LV in early diastole. We analyze simultaneously recorded dual pressure-transducer and transthoracic echocardiographic flow data obtained during cardiac catheterization in 11 subjects. We found that ZL was 2 orders of magnitude smaller than ZT in all subjects, providing the first hemodynamic evidence, in concordance with cine-MRI imaging data that longitudinal volume accommodation is indeed, nature's preferred spatial filling mechanism. We also investigated the effect of impaired diastolic function on directional impedances and found that ZL increased (becomes worse) while ZT decreased (becomes better) indicating that as diastolic function becomes impaired radial filling compensates for decreased longitudinal volume accommodation to preserve stroke volume. These results provide mechanistic insight and show that normal diastolic function defines a properly impedance matched state and that diastolic dysfunction is equivalent to a state of impedance mismatch.
UR - http://www.scopus.com/inward/record.url?scp=84870819459&partnerID=8YFLogxK
U2 - 10.1109/EMBC.2012.6347262
DO - 10.1109/EMBC.2012.6347262
M3 - Conference contribution
C2 - 23367197
AN - SCOPUS:84870819459
SN - 9781424441198
T3 - Proceedings of the Annual International Conference of the IEEE Engineering in Medicine and Biology Society, EMBS
SP - 5595
EP - 5598
BT - 2012 Annual International Conference of the IEEE Engineering in Medicine and Biology Society, EMBC 2012
T2 - 34th Annual International Conference of the IEEE Engineering in Medicine and Biology Society, EMBS 2012
Y2 - 28 August 2012 through 1 September 2012
ER -